Breastfeeding Twins Q&A

Last week I did a Breastfeeding Q&A with my friend who has a six week old baby boy and has had a very successful breastfeeding relationship so far.  My hopes and purpose for the Q&A was that it would help educate women who may be on the fence about breastfeeding and to encourage mommies who may be having difficult in their own breastfeeding journey.  I received a couple comments from pregnant twin mommies who were wondering about aspects of nursing two babies. I immediately thought of a woman from my local Natural Mamas group who was recently blessed with a set of twins. She and I actually had similarly negative experiences with the infertility clinic on post and went on to use the same RE for our IVF cycles. Again, the questions I asked are some of my own and some of them stem from debates and discussions I've observed through lurking on various forums.  I hope all of you moms of multiples out there will be encouraged by this twin mama's breastfeeding journey! It's a rocky road but it is possible to successfully breastfeed twins. Thank you so much for your help, Dasie!

Why did you want to breastfeed?
 I originally wanted to breast feed because it seemed like the most natural thing to do. I had always heard "breast is best," so I started researching when I found out I was pregnant. I was worried that I wouldn't be able to breastfeed because I was having twins. Through my research I discovered many women have been able to exclusively breastfeed their twins with no issues. I decided I was set on doing it until the babies weaned themselves.


Were you exposed to breastfeeding as a child? Was it considered "the norm" in you family culture?
Yes, breastfeeding was the norm for my family. Everyone breastfed, with the exception of my one aunt. She had medical reasons that she could not breastfeed her babies.

What did you do to prepare for breastfeeding?
I honestly didn't do much to prepare for breastfeeding. I talked to my mom about it since she had breast fed me and my brother, researched online about how best to breastfeed twins, and just talked to other mama's that I knew breast fed their babies. Other than that, the only thing I did, as suggested by my mom was to play with, tug on, and otherwise "toughen up" my nipples so they wouldn't be so sore in the beginning.

Does it really come naturally?
For me, breast feeding definitely has NOT come naturally. It is something I have worked at, struggled with, and cried over since the beginning. I am still struggling with it at 2 months in. But, it's all worth the struggle in the end to see my two little babies happy and satisfied.

What did the first latch feel like?
The first latch is really hard to explain. I was still kind of in shock from having the twins. It felt amazing, and natural (the only time breastfeeding has felt that way). It was such a once in a lifetime experience seeing my two little ones looking up at me trying to figure me out.

Did your nurses try to push formula on you in the hospital?
I truly feel like one nurse in particular pushed it on me big time. It was a night nurse I had that did the 36 hour post birth weight. She told me the babies had lost too much weight and that I needed to give them formula to supplement. I knew that giving formula would hurt my chances of being successful at EBFing, so instead I asked her to check my latch and help me that way. I thought maybe I was doing something wrong. She said that she "couldn't do that." and walked out of the room. 3 hours later, she comes back in, waking me and the babies telling me that I needed to give them formula or the babies wouldn't be allowed to leave. Of course, I broke down and gave them formula. The other nurses were nothing like this one nurse, and were in fact very supportive of me breastfeeding the babies.

My baby was screaming from hunger before my milk came in. Shouldn't I give him formula?
This one is a tough one, and I really think it is your personal decision. I came across this very situation, and I ended up giving formula. It took 8 days for my milk to come in, and the babies were just so hungry. I would give them formula through a very thin tube attached to my nipple with a syringe on the end. It helped give me the nipple stimulation I needed to establish a supply while giving them the food they needed.

What do you have against formula? It seems so much easier!
I have nothing against formula, I still give formula to my kids, but I don't think formula is easier than breast feeding. When you breastfeed all you have to do is "whip out the boob" and Voila, you're feeding your baby. This because a life saver in the middle of the night. I honestly don't know how someone would only bottle feed twins. Between the cleaning, sterilizing, heating up formula, feeding, I don't think there would be extra time left for me to relax. This all doesn't even include the cost of so many bottles and all that formula!

How long did it take for your milk to come in?
It took my milk 8 days to come in, and honestly about 10 days before I was "full" of milk. I was induced and on lasix and a bunch of other meds for pre-eclampsia, so that didn't help my milk coming in at all.

Did you see a lactation specialist in the hospital?
Yes, I saw a LC in the hospital. The one I saw was not very helpful at all. In fact, she kept pushing formula on me, but that is NOT the norm for an LC. LC's are a very valuable resource and can make or break a breastfeeding relationship.

How often do you have to feed your babies? I heard formula babies sleep longer.
In the beginning, I fed the babies every 2 hours like clockwork around the clock. Now at 2 months, they eat about every 2-3 hours during the day, and 2-3 times at night. I can say, from experience, that formula does not make them sleep longer. They still wake at the same intervals no matter what.

How do you know your baby is getting enough milk?
I know they're getting enough because they are happy and content after nursing. Babies always let you know when they are hungry.

How do you keep your supply up with twins?
Since your milk supply is based on supply and demand, I just make sure I am putting the babies to the breast very frequently. I have an underlying medical condition that causes me to have low supply, so I take a 3 capsules of fenugreek 5 times a day. I also eat a healthy diet with plenty of oatmeal and brewers yeast in it. Tandem feeding also helps keep up supply because you are being stimulated at the same time which causes a more effective let down.

Do you pump?
For the first 4 weeks I pumped, but then I stopped. Pumping didn't work for me. I couldn't let down for the pump, and all it did is hurt. I pumped in the beginning after every feeding for 10 minutes to help establish a better supply.

Has there ever been a moment where you just want to give up?
I want to give up about 2-3 times a week! Breastfeeding for me is really hard. It's not hard because I have twins or it's inconvenient, but because my medical issues make me have a lower supply. I keep on with it though, making and reaching small goals for myself. First goal was 2 weeks, then 4, then 6, now every month I give myself a pat on the back. I am hoping and praying I can make it to 6 months. Again, this is all because of my medical condition. Very few women have an actual issue with their supply.

Are your breasts sore all the time?
Honestly, my breasts have only been sore one time that I can remember. They were sore that one time because I wasn't making sure the babies were latched properly.

Do you wake up leaking?
Sometimes I wake up leaking and some times I don't. It is never that much though.

 How do you feel about nursing in public? Do you nurse in public?
I love nursing in public. I am always discreet about it, and usually do it in a carrier. I think it is good for people to see a woman nursing her baby. The more people see it, the more culturally acceptable BFing will become.

Breastfeeding is a natural thing. Why do I need to "prepare" for it?
I am really big in to education and informing yourself about options and tips and tricks related to breast feeding. There is a lot that you don't "naturally" know, and a lot of problems that you can run in to. Breast feeding may be natural process, but it is not by any means easy to do.

Do you think it's possible to be successful if you don't prepare?
I do believe it is possible to be successful if you don't prepare, but I think you are less likely to be successful. It is about the will power of the individual. I could have given up a million and a half times, but I haven't. That fact, and that alone, is why I have been successful.

Where do your babies sleep?
For convenience, the babies sleep in a pack 'n play in the living room. We have a changing station and my breastfeeding station set up there. I tandem feed through the night, so it was the easiest way for that to happen.

How does your husband feel about breastfeeding?
My husband is very supportive of my breastfeeding. Honestly, without his support, I probably would not be breastfeeding as much as I do now. He is still a little wary of me nursing in public, but still supports it. Support is so much more important than you expect it to be when breast feeding.

But aren't breasts sexual?
Breasts are sexual, and then again they are not. Breasts are sexual when it's "mommy & daddy time" but not when I am feeding my children. When I was pregnant, I thought it might be hard to feel the difference between the two, but now it really isn't at all.

My own 2 cents:
I know a lot of twin moms will come across so much negativity when expressing their wishes for breastfeeding. DON'T LISTEN!! If you want to BF your twins, then you can. Educate yourselves and don't fall prey to all the anti-BFing propaganda out there. I would highly suggest investing in a twin breast feeding pillow like "My brestfriend". It would be impossible for me to tandem feed without it. I would also start tandem feeding early on, at the hospital. There will never be a time where you have as much help as you do in the hospital. Make those nurses work for you!

Graduation!

Last night we had our 11 week ultrasound and officially graduated from the RE! It was a very bittersweet moment--words could not express our gratitude as we said our goodbyes. Our RE is also an OB/GYN so we technically could have stuck with him for prenatal care but his office is quite a drive from where we live. However, he was very supportive of the decision to go with the midwife clinic, wished us well and asked us to send him baby pictures. He's such a great guy and we will miss him!

The first thing I asked the nurse when I got there was if the ultrasound was going to be internal or external. I was so happy to find out that I could keep my pants on for this one! A HUGE milestone in the world of infertility so I made Mike take a picture. Look--no dildo cam in sight!

The baby has grown so much! (My mom attributes this growth spurt to the club sandwich I had the other day-ha!) It was really wiggling around this time and that made it difficult to get a good picture. Dr. actually commented that looking at the picture was like reading tea leaves--a Harry.Potter dork at heart? I'm going to miss him.  The baby's heart rate was 178bmp and I'm measuring four days ahead--a healthy, chubby little baby! My placenta is still over my cervix a little bit but he's confident that it will shift during my pregnancy. I have been having some pain on my left side, very similar to what I have experienced in the past and attributed to my endo. He said that my endo should be suppressed during my pregnancy but since I have adhesions, the pain that I am feeling is probably because things are shifting and pushing against my ovary that is adhered. OUCH! I hope it doesn't get too bad because it hurts! He even measured the nuchal translucency, which I wasn't expecting. Everything looked well within the normal range though and now I guess we don't have to worry about deciding whether or not to have a NT scan done. He explained that our risk of Down's is probably somewhere around 1:2000 now.

I'm so happy and relieved that everything is developing right on track. I'm finally feeling like I can start relaxing and start getting excited about this pregnancy. I'm super excited to meet with the midwife clinic on Monday and to learn more about their philosophy on child birth. I haven't had time to read all of Ina May's Guide to Childbirth so I will be borrowing most of my questions from my good friend Allie--she blogged about her natural birth plan here.  We still haven't started buying any of the big stuff but we probably will in the next several weeks, after we move on post.

Oh, the move! What a nightmare. All of you other military wives can fully appreciate the headache that is the military housing office.  We have been on the waiting list for new housing for seven months and were assured multiple times (by the same person) that we would have a house in February when our lease is up. We've already given notice to our landlord and hadn't heard anything from housing so I decided to drop an email to the housing coordinator yesterday. She acted like she had no clue we needed a house in February and told me that there are no available homes! ::headdesk:: Mike tried ringing her multiple times yesterday but she never returned his calls, even though she was clearly in her office and responding to my emails within minutes of them being sent.  The bad news is that now it looks like we're not going to get a newer home (so long  wood floors, big kitchen island and enormous laundry room) but the good news is that they DO have other homes available to us--they're just older, smaller and don't have garages. ::sigh:: We will most likely just be getting a car port, I'll have a smaller galley style kitchen and a laundry closet--BOO! The neighborhood itself is much closer to the airfield though, which is a big plus for Mike in the mornings when he's going to have to fight with traffic and because it's an older neighborhood, the trees are well established and beautiful. The newer neighborhood is closer to the freeway (noise) and there are virtually no trees around the houses since the area is only a few years old. It really, really sucks that we got screwed like this but we will try to make the best out of the situation.

Instead of this.....

We'll get something more like this:

Instead of this:

.

I will have to make do with this:

It sucks, but it is what it is. You'd think we'd be used to things not going quite as planned after dealing with the military for eight years, right? Moving on post is still the best plan for us because we spend so much on gas each month with Mike commuting nearly 40 minutes one way. Poor guy showers at the gym and naps in his car after PT because it's too far to drive home--and once I have the baby he can run home at lunch just to say hi! Another positive is that the Army is going to move us so I don't have to worry about packing anything except things like cleaning products. My mom is coming out for a couple weeks to help me clean, organize and unpack too! It will be nice to have her here! I will probably post a bump picture and my 11 week post--we have a FRG (Family Readiness Group--basically the group of spouses from Mike's unit) Bowling Party later today and I'm hoping to get a few good pictures of my growing bump. Have a great weekend, everyone!

Lucky #34?

AF finally arrived late last night, with very little spotting beforehand--a good sign of things to come?   I was hoping my severe menstrual pain would have disappeared with my endo removal but it hasn't. I still slept with a heating pad shoved between my legs.  =( Since we're still on the waiting list (and will be for quite awhile) for IVF on post, we're going to continue to do ovulation induction + IUI for now. We'll probably do another three cycles of IUI before calling it quits, which would make three IUIs pre-surgery/diagnosis and three post-surgery/endo removal.  My RE feels confident that I'll be able to get pregnant and we won't have to move to IVF, but I'm being cautiously optimistic. I'll start Femara tomorrow and hopefuly we'll be doing IUI by late next week! Here's to lucky #34

Post-op Follow Up

I had my post-surgery follow up appointment this morning. My shiny new Windows Phone makes waiting in the horrible waiting room so much less awkward. You see, the geniuses who planned the clinic set it up so the ob/gyn clinic is right next door, with the reception for both clinics in the middle of the two. So when I'm waiting for my appointments, I get to hear people on the other side of the desk booking ultrasound appointments and scheduling their prenatal care. The grass is always greener, right?

While I was waiting, a female soldier sat across from me in the waiting room. A few minutes later her husband came from the back holding a biohazard bag and exclaimed rather loudly, "Wow. That was awkward." Hahaha! I don't think he expected me to be in the waiting room. His wife handed something to him and he said, "Should I go back in the bathroom and do that?" It was all I could do to keep myself from laughing. Poor guy. I wanted to tell him that it was okay, that we'd all been there. Oh, the joys of infertility....

My follow up appointment went well. I wasn't expecting to find out anything I didn't already know since I had already seen my RE for the alien plastic two weeks ago. What I wasn't expecting was to be seen by the idiot resident who left the plastic inside me! At first I thought Dr. C. sent her in so that she could apologize to me but I was wrong. She didn't even bring it up! She checked out my incisions and made a remark about my bruising--  if only she'd seen me last week! Ouch.  When she was done checking me out she brought in Dr. C. and we discussed what our new plan of action is going to be.

If you remember my first post that I made after surgery, you will remember that the laparoscopy revealed a substantial amount of endometriosis on my left side. I was informed that my left ovary  is covered with endometriosis and is adhered to my pelvic wall at such an angle that my left fallopian tube is partially blocked. It was too risky to remove the adhesions because of their location and removing the endo from my ovary is not an option at this point, as they would likely have to take part of an otherwise healthy ovary along with the affected tissue.  As if that wasn't enough, today I found out that my left side is basically worthless and that my left tube is also partially adhered to my bowels. As much as this totally sucks, it is so incredibly refreshing to finally have some answers. EVERYTHING from our infertility, my spotting before periods, my intense menstrual cramps, my painful intercourse and the incredibly painful bowel movements during my period finally makes sense!

So, where do we go from here? Dr. C. put my mind at ease and said that my pain is normal since I'm still healing and that we won't worry about it unless I'm still in pain after six weeks. Although the majority of my endometriosis has been removed, my left side is basically unhealthy and unreliable. While I may in fact produce follicles on my left side, there's no guarantee that the eggs will go where the need to go since my tube is partially blocked. The good news is that my right side is perfectly healthy and always produces rock star follicles. Dr. C. is confident that now that our chances of conception are higher now that most of the endo is gone. Mike and I are going to continue to do ovulation induction but stick with timed intercourse for now and see where that leads us. Who knows, we may end up doing a few more IUI cycles too.

I really have a gut feeling that we're going to end up needing to do IVF to finally get our baby. I'm praying, of course, that this is not the case but I can just feel it. We're still on the waiting list for the IVF program through our military hospital and as of right now we won't be able to cycle until July of next year. They've told us that there is a good chance we could cycle in as soon as 6 to 8 months though, which would be fantastic providing we have the money saved by then. For now, we've decided to stick with the infertility clinic on post and see how the next few months go. Let's hope that we won't even have to decide between infertility clinics but instead choose between an OB or midwife!

Boy? Girl? How About a Healthy Baby!

I recently read an article that said Chad Ochocinco and his fiance plan to do IVF after their married. What's their infertility diagnosis? There isn't one! They want to do in vitro so that they can conceive twin boys--and they actually found a doctor willing to do it for that reason! I guess money really does buy you anything.

The 35-year-old Evelyn says her reasons for wanting to do IVF have nothing to do with infertility. "You don’t have to necessarily have problems getting pregnant, sometimes people do in vitro just to make sure that they get the sex that they want to get," she says. "I don’t have any fertility issues. The doctor gave me a thorough check up and said everything was fine. But it's more to make sure that I'm guaranteed a boy."
Evelyn says IVF is the norm in Hollywood. "I highly doubt that J.Lo and Mariah Carey just had twins and that everybody's having twins out of nowhere," she says. "C'mon, everybody does that now. It's common in this world."

"We told the doctor we would love to have twin boys — or at least make sure that we have a boy," she says, "and he was like, 'Hey, no problem!'  {Laughs}


Does anyone else see an issue with this?
#1 They're not infertile. They have no real medical need for in vitro fertilization. Remember my blog about people who take away valuable appointment time from real infertile couples?  Although, I'm sure it doesn't matter with the amount of money that you most likely have to pay to be seen at their clinic.
#2 They ONLY want twin boys. Not one boy. Not a boy and a girl. Just boys.
#3 The doctor's motto must be, "Show me the money!"
#4 This lady seriously belongs on the Gender Selection boards on Baby Gaga . Fellow Bumpies understand why.

First of all, who the hell is this woman? If she was on Basketball Wives then why is she engaged to a NFL player? Secondly, she makes IVF sound like a walk in the park. Either she really is an idiot or her infertility clinic ran out of informational brochures. I'm guess it's the first one.

From what I understand, gender selection isn't all that easy either. There is a process that allows doctors to separate male and female sperm but more often a technology called PGD is used. Preimplantation genetic diagnosis is a controversial procedure that allows embryos to be tested for certain genetic disorders prior to being placed back in the uterus. This procedure also allows doctors to test the embryos' gender identity. This test is controversial because embryos that test positive for genetic disorders are not transferred, but rather destroyed. In the case of Ochocinco, embryos would not be discarded because of serious, life-threatening illnesses, but simply because of their gender. I know it's not my place to judge but this is so wrong. What ever happened to wishing for a healthy baby, regardless of gender selection?

I hate that these people are essentially able to afford countless IVF cycles and we will have to scrimp and save for months just to afford one. I leave you with these thoughts.... I effing HATE infertility and celebrities are self-righteous assholes. The end.

First RE Visit

I arrived at MAMC (the hospital on Lewis) and, as usual, it was jam packed.  I parked in the first spot I could find--which happened to be the second to last furthest one away from the hospital. I practically run inside since I only have 15 minutes until my appointment is supposed to start. I went in the door that I always go in and ask the little retiree in the red vest if he could please direct me to the infertility clinic? He tells me it's in the main part of the hospital and that I have to go all the way down a hallway, make a left, and take the elevator to the third floor.  Again, I practically start running. I get on the elevator and get off on the third floor--there are no hallways or desks or anything, just a maintenance closet.  I get back on the elevator and ask a nurse if he could tell me where the IF clinic is...he doesn't know. I ask a Resident and she can't help me either because she hasn't had a 3rd floor rotation yet. I get on a different elevator and just start walking around on the 3rd floor until I find a sign--"Infertility THAT WAY." I finally found the check in desk at 1328--my appointment was scheduled for 1330. It's a damn good thing I have long legs or I would have never made it!

I got called back by a nurse pretty quickly which was great because I was worried about waiting 2+ hours the way Mike and I did for his ortho appointment. I waited a few minutes until two residents (2LTs) came in the room to take my history. Sometimes I really dislike being seen at a teaching hospital. He sat down and said, "Tell me about your history." I'm pretty sure it was like opening the gates for a race horse--I unloaded and probably talked for 5 minutes straight without letting him get a word in. :) I'm not sure if I intimidated him or what but when I handed him my charts and said, "See? I ovulate on my own and I'm just not getting pregnant!" he looked at my charts with a confused face and immediately handed them back to me. Okay...thanks. I'm so glad I took 20 minutes of my time this morning to print all of these out for you to not even look at.  Maybe it's because he's suprised that I had already been charting--I know that is one of the first things they will counsel a couple on upon arrival in their clinic. They will suggest charting and intercourse timing before testing so luckily we get to bypass that step. The other annoying thing was that he asked me the same exact questions I had to fill out on the IF Clinic Intake Form--sexual history, medical history, periods, past pregnancies, etc.  Mike and I filled it out together before he went TDY. If they're not going to read it, why did they make me fill it out? When he asked if we drank alcohol I replied, "Well...it is football season." :)After taking my history they went to talk to the doctor and they decided to do a vaginal ultrasound. Luckily I had already, ahem, prepared for this possibility and made sure everything was nice and groomed.

I really liked that Dr. C explained everything to me as he was performing the ultrasound. He took some measurements of my ovaries, told me that I probably ovulated from my right side this month, and that everything appears to be normal.  There is some fluid surrounding my uterus which he says they will keep an eye on but is nothing to be overly concerned about. I asked him about having blood work done and he said that the blood panel requested by my OB/GYN (in June after the ovarian cyst was discovered) showed normal hormone levels. I asked him if it mattered that the blood was drawn at a random point in my cycle and he said no because everything was within normal ranges. He said there may be a need in the future for CD3 and CD21 blood work but they are not ordering it at this time.

The next step is to wait for my period to start and then call to schedule an HSG--the test where a catheter is used to inject dye into my fallopian tubes to check for blockages.  Obviously we need to make sure I am not pregnant before doing this test so I get to play the waiting game for a few weeks. If that comes back all clear, Dr. C said we will discuss trying out some treatments/drugs to stimulate follicle growth in order to increase our chances of achieving pregnancy!  That's the game plan for now! I'm glad to finally have the ball rolling and now I can move on to stressing about the HSG. Ha.



The torture chamber.