Breastfeeding – Ally’s top tips and golden rules
My identical-twin boys were born at 36 weeks by C-section. Having had ambivalent feelings about breastfeeding while I was pregnant, I surprised myself after the boys were born by becoming a feeding purist (no formula apart from a handful of top-ups when I was struggling with supply in the early weeks), and then by carrying on for the relatively long time I did – a day over 20 months. I tandem fed for nearly every feed, including those done at night (for which I woke up the baby who hadn’t woken naturally). I opted for feeding the boys together as I was worried that with one-then-the-other feeding I’d end up as the breastfeeding equivalent of a chainsmoker, with almost no time to do anything else, plus there was the more powerful anxiety about having to listen to the nerve-scorching cries of one tiny baby while the other was being fed – I never managed to be pragmatic about that. Despite what the track record suggests, I’m not an unequivocal cheerleader for Breast is Best. Although for me breastfeeding twins was an often deeply moving experience, as well as one I felt was an enormous help to me in bonding with two babies, there were many, many days when it left me feeling overwhelmed, angry and resentful. Breastfeeding is natural, yes, but the difficulty is that nature isn’t interested in how you feel about what it is demanding your body does. It just demands. And keeps on demanding. But (there are lots of buts flying around on this one) on balance, I am glad I breastfed our boys. The memory-erasing effect of habitually broken sleep means I haven’t retained enough detailed facts about timings to advise on the how-much-and-when of feeding schedules in the first few months, but I can reassure you that a pattern will emerge sooner rather later – if you keep plugging away, trying to stick to regularish intervals, you should regain some sense of control before too long. I hope the following advice on the stuff I do remember fairly clearly about getting started with breastfeeding twins is useful.
Do your reading
Breastfeeding twins in tandem is not equivalent to feeding a single baby times two: the holds are different, the emotional dimension is different (there is a group dynamic, so the bonding process is not the same), and lots of the equipment seems designed to turn you into a bit of a sideshow – I called my set up for tandem feeding using my body-wrapping pillow ‘boobs on a shelf’. Nearly all of the literature about breastfeeding seems off the mark for twin mums as so much of it focuses, rightly enough, on the joys of bonding with your one child and the importance of mastering lie-down feeding – the unattainable Holy Grail for nearly all tandem feeders, including myself (how the hell?!). My feeling is that it’s well worth ignoring those who advise you when you are pregnant not to worry yourself with too much research and forethought – like a good boy scout, a prospective mother of twins must Be Prepared. Read everything you can that is specific to breastfeeding twins (there will be little time to do so once the babies arrive, and you will be a bit bent of brain with lack of sleep, so unable to focus, anyway), and hassle the hospital to get you a place on a specialist antenatal workshop or an appointment with a breastfeeding counseller before rather than after the babies are born. And talk to anyone you can get hold of who has breastfed twins, even if they are strangers – if you ask, most mums who have done it will gladly share their experience. Digesting targetted information about holds, getting babies latched and building up milk supply, etc., will really help build the feeling that you will be able to breastfeed, come the time – I think confidence is central to the success of breastfeeding (as well as, most likely, a dash of luck). If you know the principles before you begin (for example, that with breastfeeding you’ll struggle to get to the four-hourly feeding schedule so many people tell you is ‘normal’ for babies in the months before weaning, because that rule is based on the tummy-filling nature of formula), you’re more likely to carry on, and to be able to conquer your anxieties when things don’t work according to plan.
Don’t rely on the hospital
About six months into my pregnancy, unnerved by pictures I’d seen of women cheerily using industrial-looking tandem holds, and awash with doubts about how I’d cope (why send two babies to me, of all people?), I ignored our limited finances and my default squeamishness about asking for help and booked a short series of postnatal visits from a doula who had a particular interest in supporting breastfeeding. The money we spent on time with our fantastic doula, Kathi – who was with us the day of the C-section, then in the hospital for a few hours each day, then on and off for the first six or so weeks at home – was by far the best investment we made on the boys’ behalf. Her calm, well-informed and unsentimental advice on the benefits, demands and logistical challenges of breastfeeding was a major factor in my having the confidence and belief to carry on through the first, very difficult and tiring period of feeding the boys. (We also had a lot of laughs together – there is natural comedy in the boobs-out, babies-sliding-around slapstick of learning to tandem-breastfeed twins.) In particular, Kathi was an invaluable support during the surreal, sleep-starved week in the hospital. Without her advice and perspective, it would have been easy to be bullied by desperation for sleep and anxiety about the boy’s low blood sugar into relying on more and more formula feeds. Born around a month early, the boys’ sucking reflex was quite weak for the first few days before my milk came in, so they were cup fed by the midwives and I was struggling to express enough colostrum to keep up with demand. Stocks of donated breastmilk were low then ran out, so the boys were given one or two formula feeds to keep them out of the woods (one, in the middle of the night – I guess because I had said yes to one already the day before – without my consent). It may have been that the ward was short-staffed the week we were there, and, possibly, that some of the midwives had met Kathi and knew she was helping me, as well as the fact that I didn’t directly ask for it, but I don’t remember anyone offering me specific ‘how you do it’-style advice on breastfeeding, other than how to work the breastpump once my milk had come in. We did meet a specialist breastfeeding nurse at one point, but I think (my memory of the week is very impressionistic) that she came just to give an opinion about how the boys’ low blood sugar was being managed. I remember expecting her to be really encouraging and to ask me lots of questions about what I was doing, or at least to suggest some strategies for how to cope with the double feeding once we left the hospital, but she only stayed a few minutes. Based on my experience, the days of midwives having time to show you how to feed, bath and dress Baby are most definitely over. The hospital staff we met were mostly extremely kind and supportive (there is definitely extra sympathy for parents of twins), but there was certainly no time for them to coach you through each day’s feeding challenges. It seemed, rightly enough, that their focus was on making sure enough food went into the boys to keep them out of danger, rather than on where that food came from. But I was surprised by how understated and seemingly uncoordinated the hospital’s breastfeeding-support programme was given that the NHS is avowedly so pro-breastfeeding. I expected a Thou Shalt Breastfeed speech, but it didn’t come; I thought I’d be given some detailed information about breastfeeding, explaining what you should be doing, day by day, but I wasn’t (to be fair, there was information in the going-home pack about the importance of breastfeeding, but it was all broad-brushstrokes stuff). Possibly midwives judge how interested you seem in breastfeeding and then make assumptions about what you know. Or maybe it’s simply a case that as with most branches of the modern NHS, there’s too much to do with too little resources. So, my advice would be, if you can, to spend a bit of money on someone (a lactation consultant or a doula with the right experience) coming into the hospital to help get you started with feeding, even if it’s only for one or two sessions. The right expert advice at the right time can be crucial – I know from talking to a number of twin-mum friends that they felt they would have carried on feeding if they’d been better supported in the first few days.
Sort out your set up
I can’t stress this enough: you need to work out how to make tandem feeding comfortable, and have the right things in place before the babies are born – you won’t be doing much online research or shopping after they arrive. I bought an Easy 2 Nurse inflatable cushion a month or so before the boys were born (recoiling at the image on the box of a woman using hers wearing a mumsy smock and an ‘isn’t this swell?!’ grin), and after my milk came in, used it to tandem feed the boys in the hospital. I would heartily recommend shelling out and buying a proper twins feeding cushion – and advise that you get a foam not an inflatable one (you won’t be travelling much or at all, so the benefits of a blow-up are minimal, and it could, as mine did, get a puncture and seriously mess with your feeding programme). Don’t assume that a pile of pillows or a larger conventional feeding cushion will do. You need something that gives you enough working room for the babies to lie comfortably on either side of you with their whole bodies supported, and that gets them up to the right height to reach your nipples – with two babies finally attached and happy, you don’t want any slippage. Plus, with both babies happily ‘on’, it is possible to do other things with your two (two!) free hands. I even managed to send emails, and to write many, many (generally futile) To Do lists while feeding. But… even with a proper twins cushion, about a month into the feeding I got stabbing pains in my back from all the awkward hunching over that I was doing. My back wasn’t getting the support it needed, either when I was feeding in bed at night or on the sofa during the day. My partner came up with the idea of a small, partially inflated gym ball – which was perfect for leaning against, unlike pillows, which always seem to melt sideways by the middle of a feed.
Learn to go it alone
Most of the information I read on tandem-breastfeeding twins seemed to focus on the likes of perfecting the holds, dealing with supply issues and attempting to develop a schedule, but I think there needs to be a lot more said about perfecting the trick of getting the babies onto the feeding cushion when you are on your own – tricky but crucial. I was dreading the day that my partner was back at work and nobody else was around either to hand me one baby then another so I could start feeding.
I eventually worked out a system that involved the following: strapping on my Easy 2 Nurse cushion (it comes with a comically industrial-looking clip belt); getting one baby out of the day cot and laying him on a singleton feeding pillow (curved and tied into a doughnut shape to stop him rolling off, and balanced on a sofa cushion to lift him to the same height as the feeding cushion); getting the second baby out of the cot and putting him on the feeding cushion and latching him on; then lifting the first baby sideways, crane-style by his babygro, onto the feeding pillow, and latching him on too. (I detail this in case it’s useful – it took me quite a while to figure out a system that worked.) Once you’ve mastered it, you’ll feel so damn proud of yourself. I know I did. And also, suddenly, there’s the freedom to be with your babies on your own. Having been surrounded by other people for weeks, this may not seem the terrifying prospect it will have done just after the birth.
Learn to embrace local life
Breastfeeding twins, particularly tandem breastfeeding twins, doesn’t offer the no-strings-attached benefits of breastfeeding a single baby (no bottles, no heating up, no real sight of body parts with a pashmina handy, yadda yadda), unless you are the kind of person who is not phased by getting what looks like a giant foam-filled magnet out in a cafe and feeding two babies at once, with most of your breasts showing. I’m not that easily embarrassed, but tandem feeding in public was beyond me (except when the boys were about six-months old, and, in a moment of madness, I fed them, huge cushion and all, in St James’s Park, drawing attention from two tactlessly fascinated Italian students). Being the other side of the experience, I advise that if you are committed to breastfeeding and, hard though it might be, that you try to savour a local life – you certainly won’t want to get much beyond the local park for fear of not being able to get home in time to do the next feed (how fixated I became on clocks, and how intolerant of slow-moving mothers-in-law!). Also, join the local twins club and try and find someone local – ideally within walking distance – who is also having twins around the same time you are. I was lucky enough to find someone local with twins three weeks younger than mine who I instantly clicked with (a do-or-die meeting that had, of necessity, to be conducted while I attempted a new and very unsubtle tandem-feeding hold, virtually naked from the waist up), and she has been a huge support ever since – without her to moan to and be ironic with, the whole experience would have been much, much harder. That, in a sense, is what I think is the most important bit of advice for anyone who is having twins, breastfeeding or not: find other people locally who are in the same situation because, for good and bad, having twins is not the same experience as having a single child. You crave the company of someone who understands. Having the boys has given me the opportunity to meet and quickly get to know some really great people, ones with whom I have a bond based on sharing tough, funny and confusing times. Aside from the joy of our two boys, that was well worth having twins for.
Ally from Nunhead, mum to Jack and Arlo, 2