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On episode 11 of the Double Happiness Multiplied podcast, we talk about breast and bottle feeding.
Lactation Consultant Judy Adams, who is also a twin mum, gives us advice about breastfeeding multiples and also shares her story of the pressure she felt to exclusively breastfeed her boys.
Twin mum Rebecca Perrie and mum of Quadruplets Jannelle Snaddon also join us to talk about supplementing with formula to get some rest.
Lactation Consultant Judy Adams from King Edward Memorial Hospital in Western Australia tells us, the business of breastfeeding multiples isn’t easy and many women feel enormous pressure to exclusively breastfeed their babies, which is often an incredible emotional upheaval especially if the babies are born preterm.
When you have three babies, breastfeeding is another story. Judy explains that in this situation, some mums often choose to twin feed and then give expressed breast milk to the third baby, while other mums choose to do replacement feeds with expressed breast milk.
Is it important to introduce the bottle as well as the breast?
Judy says she tries to be very open-minded about it, and part of being a preterm baby means that you have to have bottles, you can’t go home unless you can suck all of your feeds. However, creating an individualised plan with the mum as to what the maximum amount of breastfeeding she can do is the best strategy.
If the babies are still in the Neonatal Intensive Care Unit at 37-weeks’ gestation, Judy says specialised teats are used to help make the baby suck.
Supplementing with formula
The baby has to be able to grow, that’s the bottom line. So, if mum hasn’t got enough breast milk then you don’t have any option and formula is a necessity. And, if the baby isn’t thriving then you’re running into all sorts of other problem, explains Judy.
“As hard as it is, I know very well myself, I burst into tears when I first bought formula, and I ended up throwing it out anyway,”
“But it’s very emotional, you’re in the supermarket and you reach for it, and then you put it back, and then you reach for it again, and I thought I better have some just in case,” says Judy.
Some mums don’t have a choice. Whether for health reasons or some other complication, some mums can’t provide milk for their baby, and they shouldn’t feel guilty that they’re giving their babies formula.
We’ve spoken about nutrition during your pregnancy on Episode Three of this season, but Judy tells us it’s just as important to monitor your diet while you’re breastfeeding.
Water is incredibly important when you're breastfeeding and the best guide is to drink to your thirst, however, if you’re not someone who gets thirsty you should aim for about two-litres of water per day.
Foods to avoid
There are all sorts of myths about fried onions and broccoli and all sorts of things but Judy says you should eat a normal diet, in moderation.
So, if you love chocolate, Judy says it's okay to have a bit but just don't eat the entire bar in one sitting.
The rule of thumb is to stick to your normal triangle of fruit, veg, and cereals.
And remember, if it upsets you it’ll probably upset the babies.
Rebecca Perrie says having gestational diabetes during her twin pregnancy meant her girls needed some nutritional support after they were born. She admits that after breastfeeding her daughter two years earlier, attempting to breastfeed two babies at once was a whole different story.
“They were tube fed on the first day even because their sugars dropped a little bit. So, we always had formula there as part of their lives from the very beginning,”
“I breastfed with my first child until she was four-months but she lost quite a bit of weight and I hadn’t noticed, so we also introduced formula to my eldest one,”
“So, I knew that formula may be something that we would be using with the twins anyway, but I was going to try my hardest to get the golden liquid, you know the golden medicine, the magical stuff into them,” says Rebecca.
Rebecca says her determination to breastfeed her twins meant she pretty much didn’t have a top on for the entire summer. She says she would feed one, then feed the other, then express for a while and try and get as much into them as possible.
Jannelle Snaddon laughed when I asked her about breastfeeding her quadruplets. She admits she gave it a go, but it didn’t last that long.
“To start with my kids were lucky enough, they actually had donor breast milk while they were in hospital,”
“I was in recovery so I couldn’t express straight away,”
“I think it was a good few days or even week possibly that I was able to start expressing myself,” says Jannelle.
Jannelle remembers getting hold of the electric breast pump and expressing constantly.
“A lot of people say normally with multiples you do produce a fair bit of milk, I didn’t produce a lot,”
“I spent all of the day and most of the night with the babies, but that middle of the night where I’d wake up to express but my babies aren’t here was a very odd feeling,”
“I was lucky I suppose because they were so small and I managed to get them to about most of the hospital journey, maybe six-weeks they had solely breast milk,” Jannelle says.
Jannelle attempted breastfeeding while her babies were still in the hospital, however, with four babies it was a huge task just trying to get them to latch. So, most of the time was spent expressing and trying to increase her milk supply.
“I remember getting home and I’d bought one of those twin pillows thinking that yes, I’ve got this, and I put two babies on, and then I just looked at Matt and said, ‘go make the bottles’,” says Jannelle.
Although Judy Adams is a lactation consultant and had guided hundreds of women through the initial stages of breastfeeding, she admits she found it difficult when it came to feeding her own twins.
When Judy had her babies, they were just short of 35-weeks’ gestation, she admits they were big boys but they were still tube fed for a while. Judy tells us that when it came to using the electric breast pump she had to be shown how.
“I’d shown dozens, that’s all I do show women how to express, but I’d never expressed my breasts myself,”
“I found it hard being a mum and not being a lactation consultant/neonatal nurse. It was difficult,”
“I had this huge pressure that I had to succeed at this because this is what I do. But I was very, very lucky I had two very hungry babies who just wanted to feed all the time,” says Judy.
Judy was fortunate in that twin feeding worked out well for her. And, she credits the support of her husband for being able to achieve it.
“It was a beautiful experience for me,”
“But, I’m well aware of the challenges, I had mastitis three times so that was pretty ordinary, and I nearly gave up, well I had pressure to give up,”
“But, I was determined,” she adds.
For me, well the girls spent the first 3-months in hospital following their birth, so initially, I expressed breast milk every three hours. At first, there wasn’t much but as time went on my supply increased … slightly.
By the time we left the hospital, I had a large freezer full of milk because in those early days the girls were only having such small amounts.
Bella preferred the breast, whereas with Aasha I could alternate between breast and bottle. However, my supply didn’t grow with the girls and my frozen supply ran out when the girls had been home for about four months.
I tried to switch to formula because I just didn’t have much milk, which worked okay for Aasha but Bella refused the bottle. I bought every type of bottle I could find but nothing seemed to please her, it was such a stressful time as they were still so small from being born at 28-weeks’ gestation and I was so worried Bella would get sick
Then one day, while the girls were sitting next to each other the floor, Bella reached over and grabbed Aasha’s bottle and started drinking. And, it continued from there.
When breastfeeding, you need to eat your normal triangle of fruit, vegetables, and cereals.
If a food upsets you it’ll probably upset the baby.
A full-term singleton baby needs 500mls of breastmilk per day, so for twins, it’s a litre, and for triplets, it’s 1.5 litres, etc.
Eat your normal diet, in moderation.
The bottom line is that your babies need to grow, so if you need to supplement with formula, go for it.
Coming up on the next episode, we discuss the different avenues people take to address their grief when things don’t go the way they hoped during their multiple pregnancies.
Alexa Bigwarfe tells us how she turned to advocacy to help her heal following the passing of one of her twin daughters, just two days after her birth.
Scott Beedie gives us a dad’s perspective of the emotional struggle and turmoil he experienced when he was told one of his twin’s hearts had stopped beating just after 20-weeks’ gestation.
And, Psychologist Dr Gretta Little shares some advice on recognising when it’s time you need to get some professional help to deal with your emotions.
Until next time.
I wish you Double Happiness Multiplied.
Double Happiness Multiplied - What you need to know about having Twins, Triplets, & Quads:
Double Happiness Multiplied
Australian Breastfeeding Association
Association of Breastfeeding Mothers
Helping Little Hands
Australian Multiple Birth Association
Perth & Districts Multiple Birth Association
Multiples of America
Twins & Multiple Births Association
The Multiple Births Foundation
Irish Multiple Births Association
Multiple Births Canada
International Council of Multiple Birth Organisations (ICOMBO)
South African Multiple Birth Association
Podcast music by:
Catherine Ashley Harpist