Wednesday 13 August 2014

Breastfeeding Two - a "TimeHop" post

Now... whilst it is some years since that was my reality, I wrote a few articles about my breastfeeding views and experiences and had a couple published. Never one to turn down a writing opportunity, here is my "Breastfeeding Two" article written for La Leche League in their Spring newsletter 2007 when the twins were one.

I must stress that this was written for a purpose, for a magazine whose raison d'ĂȘtre was the promotion of breastfeeding - which I wholeheartedly support but it does affect the tone of the article.

Breastfeeding Two


I awaited the arrival of our twins eagerly. I was excited about breastfeeding two, I had not managed to breastfeed my eldest son beyond 8 weeks due to latching problems causing engorgement, his reflux, and the need to return to full time work when he was only 12 weeks old. I fed my second son to nearly 8 months but it was far from easy. We now know the difficulties were largely due to his Asperger’s Syndrome (he hated facing into me and being cuddled close) and he too suffered from reflux pain but at the time it was only sheer determination on my part which kept me breastfeeding.



Unfortunately things were not easy with the twins either. They did latch on and fed beautifully straight after what was by far the easiest delivery of all mine. But they failed to thrive and took 6 and 8 weeks to regain their birth weights. This was largely due to the fact that they too suffered from severe Gastro-oesophageal reflux and gut inflammation (now diagnosed with EGID) , which was complicated by food allergies. They would both reflux back nearly all their feed each time and I would have to feed them again. So in reality I wasn’t just feeding twins, more like quads! With two older children to care for it was hard going, and my twins fed every half an hour.

I have written about GERD (reflux) on my Recipe Blog - an article approved by a paediatric gastroenterologist at the time.

I knew if I had any chance of succeeding I had to demand feed. With their failure to thrive routine-based feeding would never work. We co-slept for a few months, with a bed guard at my side of our super king-size bed, the twins side by side then me facing them. Otherwise I would literally have been up all night every night feeding. At least this way I could latch them on one by one and sleep whilst feeding. We had a single cellular blanket over us and it worked so well. After that I had them in a cot bed together next to my bed.

By week three we were referred urgently to our local Children’s Day Unit at the General Hospital, where supplementation with formula was pushed on me. However, I was better informed than when my eldest was suffering and refused to give way without trying all options. I knew that breast milk is a natural antacid and ideal for acid-splashed throats. Formula is acidic and would aggravate the problem, plus I knew that they ingested plenty of milk from me - the problem was keeping it down! I had a fast let-down so I tried to feed them “uphill”, or take them off a few seconds and let the fast-flowing milk soak into a muslin before putting them back to the breast to feed. This helped a little, but they were still very windy babies, winding would take literally an hour sometimes, and would run into the next feed. If any wind were left they would bring up all the milk on top of it in their stomachs.

We tried several medications, of increasing strength to try and damp down their reflux symptoms. At 8 weeks I gave in and agreed to try 1-2 oz of thickened formula once or twice a day. It seemed bizarre really, I had two of the best breastfeeding babies I had seen, and they both latched beautifully, and fed really, really well. It was the reflux causing the problems and I was miserable about having to consider supplementation, believing it to be the “thin end of the wedge”. I also felt the push to formula feed was missing the point - the feeding was not the issue!

I had not managed to feed them together well since they needed to be kept upright after a feed, and with only two hands I could not wind one then the other. Feeding them one at a time worked for me thought, I had lovely cuddles with each in turn, although invariably the second twin would become upset waiting. I gave them dummies, which whilst not ideal, never interfered with the feeding in my experience and gave some comfort whilst waiting. Sucking also helps with reflux since it produces saliva. I was still spending most waking moments feeding one then the other though, and their weights were static.

The single ounce of formula per baby per day that they both tried produced more problems. K became very, very constipated, sometimes going 9 days without a motion. Twice we ended up at the Day Unit (where we went every week for almost a year and still attend monthly) for glycerine chips to help her “go”. A’s reflux was aggravated by it too and we were switched to a hypoallergenic formula. I also cut out all dairy in my diet at 12 weeks and things really started to improve. I then cut out Soya and all caffeine (I was barely having any but stopped my morning cup of tea) and we were beginning to see some progress. On medication (Proton Pump Inhibitors to damp down the acid, motility agents to speed food through the gut and later lactulose and anti-allergy medication) and my restricted diet we continued on almost breast milk alone. I really enjoyed feeding the twins and used the formula to top up when they regurgitated all their breast milk.

Topping up for us really did not signal the end of breastfeeding as it can for so many mums. I was very careful to use it wisely, and managed to breastfeed them approximately 95% of the time. I did not introduce any solids until 6 months, but sadly they still have food allergies. K is allergic to Dairy, Soya, Wheat and Gluten and A is allergic to Dairy (extreme reaction), Soya, and Wheat. They were breastfed on demand until 16 months old. At that age they tandem fed every time, as I could sit one on each knee and not worry about supporting them to the same extent. It was lovely to feed them together; a real bonding moment. Breastfeeding was a wonderful experience and I would most definitely not do anything differently given another chance. Their reflux really made it a battle, but a battle I would happily fight for any of my children, and one which has brought much joy for all three of us and also health benefits for the twins.

The key issue for us was focussing on the health issues to improve growth etc not the feeding, they fed well! Sadly breastfeeding is often blamed as a "catch all" when babies don't gain weight but is often not the problem.




The UK has one of the lowest rates of breastfeeding by six months in the West.

I totally believe that our low nursing rates in this country are as much due to lack of information as lack of support. It is our expectations that are at fault, and lack of community/family support. Mothers don't expect to be tied to a highly dependent baby for the first months and want freedom and independence. They are led to believe babies should "sleep through" and last many hours between feeds. The decades of four-hourly feed indoctrination and unlikely sleep expectations will clearly take many years to overturn but until popular understanding of babies’ behaviour changes, and breastfeeding becomes the expected "norm" rather than an option little will change.

Breastfeeding has been one of the most rewarding things I have ever done, but I faced many struggles each time – and many of these were unnecessary. Better information and support would make a world of difference. The website www.kellymom.com is a fantastic site, I cannot recommend it enough, and removing expectations that your baby will do anything at a given time is great advice. Knowing that every three months you will be feeding round the clock for a day or two during a growth spurt is essential knowledge - this is how your baby increases your milk supply. It is not only normal - but necessary. And the three month old who sleeps well will most likely no longer sleep well at four months - they undergo such a radical physical and developmental growth spurt and can see further, are aware of being alone and interact more with their environment. Life is too exciting to SLEEP!
And forget sleeping through the night - your milk is at its best in the small hours whilst you rest and anthropologically this was when it was safest to feed your baby.

Until mothers are better informed and have more realistic expectations breastfeeding rates in this country are unlikely to change. Our have-it-all, constantly rushing around society doesn't have much room for sitting quietly breastfeeding a baby. There is always too much to do - which I find very sad. For those who can't - there are excellent alternatives, but I don't believe mothers are given the real choice in the first place.




Useful Links

Tips for breastfeeding Multiples from La Leche League
Information on Milk Protein Allergy
Advice on weaning babies with reflux



Linking up with

Adventures of a Novice Mum

28 comments:

  1. Due to medications I was unable to breast feed. I beat myself up for a long time over it, but no longer!

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  2. I think we do need more support in this country with breastfeeding. There is a lot of judgmental attitudes towards women who have genuine problems (not like the woman you mentioned) and decide to bottle feed too however. I am glad you managed to in the end.

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  3. It really saddens me the number of pregnant women who have already made the decision to bottle feed so their partners can help out. We are the only species that routinely drinks the milk of another species. How unnatural is that?

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  4. I didn't want to breastfeed, but each to their own. Lovely to hear your story x

    http://www.youbabymemummy.com

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  5. Good for you. I think there's too much pressure to use formula if things aren't good perfectly. By standing by a decision to continue to breastfeed people seem to think it's like you are saying there's something wrong with it. My older of my 2 youngest (who fed at the same time) threw up all his feeds all the time, didn't know there was a name for it.

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  6. You did very well to continue when many others would have given up. I do feel strongly though that people who are unable or unwilling to breast feed should have their choice accepted as much as we should accept others choice to breastfeed.

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    1. Except where does that concept of choice one from? From the belief that breasts are not functional but for sexual purposes? From the incorrect assumption that formula is an equivalent substitute? From society's pressures that have overly high expectations of new mothers? Governments pushing women back into work and children into childcare options? The misguided belief that a baby is somehow part-time? Or the historic community and family support in modern society? Because although it's easier to offer a bottle to a new mum in hospital than sit with them for an hour helping establish breastfeeding it is actually removing choice. We would think it bizarre if puppies were routinely bottle-fed cat milk instead of suckling from their mum, yet that has been the reality for humans in recent years. It's time to rethink our attitudes, not judge individuals :)

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    2. I'm breastfeeding and it's going brilliantly, except that my son has silent reflux and the first medicine he was given made him constipated. I'm waiting for an appointment to change the meds and I'll remove dairy from my diet once I can see if the medicine works or not. You did amazingly well!

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    3. Was that Gaviscon? That is notorious for slowing the gut down, which obv makes reflux worse. Infant Gavison has a thickener in it too - different from adult Gaviscon which is just an antacid. Hopefully they can offer something like Ranitidine, but that's VERY weight dependent and the dose needs checking regularly. I've added lots of info on my other Blog - http://thereciperesource.blogspot.co.uk/p/dealing-with-infant-reflux.html

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  7. this is a bit of a sad post...of COURSE people should be encouraged to breast feed. But of course it is about what works for you!

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    1. Why "sad"? It's written for a linky raising awareness for breastfeeding, or rather the realities not the assumptions. I'm not sure that's sad?

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  8. Good for you for persisting. Sadly I was unable to breastfeed both of mine (not for want of trying!) and really wish i was able to. They both thrived on formula though so not a total disaster. Great post!

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  9. That must have been hard work!

    My son was transferred to a hospital almost an hour away from me when he was a few hours old, so they could perform a necessary surgery, but they didn't take me with him. My first night in hospital I expressed every few hours all night, even though I could have just slept as I was in a room on my own. I expressed constantly, even whilst he was still in hospital and I only saw him a couple of hours a day. We tried breast feeding when he finally came back to our local hospital, we had the latch down but I just wasn't producing enough milk for him, the expressing wasn't enough.

    The stress of a sick baby and the distance and time issues meant it just didn't work for us and it makes me sad as the few times we did do it were utterly magical.

    My son developed very bad reflux, though, too so I expect that I wouldn't have enjoyed it so much had I had to experience him bringing his milk back up during a feed when his feed was coming from me... yes, not a nice idea. Reflux is Nasty, my son suffered with it badly for over a year, and he's still very quick to be sick if he cries of coughs a lot (even though he's four)

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  10. Sadly I was unable to breast feed due to my son being born seven weeks prematurely (born at 33 weeks), my milk was barely existent and the little bit of milk I did have at the beginning did not go to it's destination due to my son's severe son tie. Then my son had a emergency operation at 3 weeks old after being in special care and breast feeding and trying to keep what little milk I had multiplying was just the last thing on my mind.

    My mum couldn't breast feed due to a personal issue and all of her children have turned out all-right with three out of the four of us gaining excellent grades in our exams (my youngest sister is only 12, and therefore not sat her exams yet) and two of the three older ones between us attending university and graduating with excellent results.

    I'm so glad that breastfeeding is a option and it really annoys me with the negativity swimming around at the minute with breast feeding mothers being discriminated from certain retailers because their children are hungry! However, I do wish formula and milk was accepted equally, there is no worse feeling then feeling awful for not doing something that is deemed as the best for your child, when both you and your child had problems to prevent that x

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    1. Do you think that if breastfeeding were seen more as the "norm" then the minority who persistently discriminate against individuals would be more understanding? I wrote this years ago, and having struggling with Eosinophilic Disease for years and understanding more about the illness I have to say if I had had another baby I would probably have formula few elemental formula from very early on. Retrospectively I am furious that no one stepped in to help my twins earlier, the immediate issue wasn't what went in, but that it didn't stay down for them to thrive!

      This was written in 2007, years earlier I wrote another piece for the NCT newsletter on my experiences with my eldest, whom I couldn't breastfeed about the negativity mothers who really can't BF face. Such a minefield! Thanks for commenting!

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  11. Breastfeeding is such a wonderful, and wonderfully difficult, rewarding experience. New mom's are full of such unrealistic expectations, that some just don't give it enough time. I've nursed five children for at least a year, and I always say that for at least that year they liked my cooking. I was allergic to my own mother's medications. My mother nursed me for nine months while I wailed at her, non stop. I am amazed she put up with me for as long as she did (I was her fifth child). Mom's need to do what is best for their children. Our society usually pushes doing what's best for the grownup in a lot of parenting issues. Maybe an honest discussion needs to begin about what is really best for our children and our mothers. Thank you for your post.
    www.mommycrusader.com

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  12. Hello!

    I wrote a post last week which echoed a bit what you said in your last couple of paragraphs.

    (If you're interested, this is the link http://bettyandthebumps.com/2014/08/07/happy-world-breastfeeding-week/)

    For the record, while I breastfed for 10 months, we used formula from day 2. It was on the advice of midwives at first and I cried and cried about it. So I am not coming from the perspective of an exclusive breastfeeder.

    But anyway, I agree that the reasons that rates are so low in the UK is that our expectations of life after having a baby are too high. I'm not sure if that's the most articulate way of putting it but if you expect your body to snap back and have a baby that sleeps through and enjoy "date nights" ASAP then you won't find that easy if you breastfeed.

    I'm not saying there's anything wrong with wanting unbroken sleep or wanting to socialise etc etc, I'm just saying those things aren't compatible with having a baby permanently attached to your chest.

    I am not interested in any of those things (well, maybe the sleep bit!!) but I still found the demands cluster feeding and comfort feeding a shock.

    Well done for sticking to your guns. It was obviously really important to you. I do wish I had tried harder to get Gwenn off formula before it was too late but I'm still really pleased with what I achieved.

    x

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  13. Well done for breastfeeding two - I have fed all my children but never had twins and that was tough enough at times!

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  14. As I'm not a mum it's a bit hard for me to be able to relate to this post, but I know my sister wanted to breast feed with both my nephews but neither would take to it, which she beat her self up about, and I remember at the time not understanding why she was so down about it. Personally when I become a mother I already know I wont breast feed, because it will be my choice and I have no desire to breast feed, my mum didn't breast feed with any of her 5 children and there is nothing wrong with any of us, we all turned out fine and that's all the matters to me, but of course, my opinions could change.

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    1. But it's an odd choice initially don't you think? Fine if you run into problems - but you don't see other baby mammals given such a "choice"? There are no cans of feline formula for puppies, or cows milk formula for kittens - it would be unthinkable in all but necessary/unavoidable situations! So where has this concept of "choice" come from? Historically wealthy ladies had wet nurses for their babies - but also had very little to do with them at any other time.

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  15. I imagine it must have been exhausting feeding two but really rewarding too. I support everyone's choice - I wish people would choose breastfeeding first but I also know what problems people can have and how many are forced to bottle feed because of this, so it's ultimately it's about whatever works for you.

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  16. Well done. I formula fed my eldest because of problems, and I think the guilt contributed to my PND. I then breastfed my second for 21 months, until he self weaned (which I think was down to me being pregnant). I have made the decision to breastfeed our third for the first couple of days and then move onto formula - which this time I refuse to feel guilty about. Breast is best without a doubt, but formula is a good enough alternative, and I always think a happy mum is also a happy baby.

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  17. You make the over arching point so well that there is such a lot to breastfeeding and I'm in complete awe of your knowledge. Thanks so much for sharing this post with my linky #BFingDiaries, I think it will really help better inform Mums who are faced with complex issues and nursing.

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  18. Great post I breastfed my youngest till he was 3, his choice not mine! I struggled with my eldest but with my other two it was much easier.

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  19. amazing you were able to breastfeed twins! Well done you, I defo think there needs to be more support out there. I've just ended my breastfeeding journey with my son (at two and a half years!) x

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  20. Great post - I'm in awe that you managed to breastfeed twins. I struggled a lot with number one, but breastfed my other two children. It's an amazing experience but in no way easy, and even without twins, it was often a battle. But very very much worth it.

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  21. I combine fed my first which I found difficult - attitudes 17 years ago were less 'pro' breastfeeding & i breastfed my daughter until she self weaned just before her 2nd birthday. I was lazy/tired mum and on the whole it was easier to BF then to prepare a bottle!!

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  22. Thanks for linking your post to #BreastfeedingandI, what an interesting read.

    Knowledge is power, isn't it, when it comes to breastfeeding and many other areas in life. It's helpful to read about how much you understood the situation with your twins despite the weight focus of the health professionals that worked with you. Well done for fighting your children's corner in the way that you knew to and for pesevering through all the challenges you faced.

    What a beautiful picture of both of them tandem nursing; and feeding on demand until 16 months is not the easiest. I'm on that journey with my toddler and I sometimes struggle with the timing of his requests.

    Indeed breastfeeding rates in the UK will not improve and the shock of being a new mum will not lessen, except mums are better informed and have more realistic expectations of their baby's needs in the early days, weeks, months, and even years. #BreastfeedingandI

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Many thanks for taking the time to comment, I really value your responses.

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