Twin peaks: my experience of tandem feeding twins

Part of the Yes Bebe breast feeding series for World Breastfeeding Week 2018: <<read more>>

Premature

twins, premature, kangaroo cuddles, skin-to-skinMy twins were born at 34 weeks by emergency c-section. My husband got to hold twin A (Hal) while twin B (Conall) tried in vain to escape the consultant’s clutches and hide under my ribs. While Hal wanted out, Conall was definitely not ready to be born yet, a fact which became even clearer when he began to struggle to breathe. He was whipped off to the NNU and straight onto breathing apparatus without my even glimpsing his face. Hal followed shortly afterwards, and it would be almost 36 hours before I’d get to see either of my boys again.

I tell you this because I genuinely believe it affected my breastfeeding journey. The lack of instant physical bond was a barrier that would prove difficult to overcome. Being 6 weeks premature, the twins’ sucking reflex was not strong enough to breastfeed, neither were their tongues strong enough to initiate latch. A few weeks down the line we would overcome this with the help of nipple shields, an aid I know gets a lot of bad press, but which were the lynchpin factor that enabled me to fulfil my ambition to feed them at all.

Guilt, self-blame and NHS angels

twins, incubator, neonatal, tube-feedingWhen your babies are struggling in the NNU/NICU/PICU there can be a surprising amount of pressure on you to change the way you feel about feeding. I always hoped to breastfeed my twins, but the NNU staff’s priority was not actually to adhere to my wishes, but to care for my babies – for which I will be eternally gratfeul. So when, 3 days later, my milk still hadn’t come in and my twins were still incubated and tube-feeding, they decided to top them up with formula. I hated it. I felt desperately guilty and blamed myself and my body for failing them.

Later that night, while sobbing inconsolably at 4am, I was approached by the Ward Sister. There had been a staff change the previous evening and as I had been crying non-stop for several hours, she had left me to the very end of her rounds so that she could spend a little time with me. She asked me what was the matter. I showed her the tiny syringe of colostrum I had managed to produce, tinged brown by my blood. She asked me when I had last slept through the night. I explained that I was waking every three hours to attempt to pump, as had been recommended. She asked when I had last had painkillers or a meal. I explained that I hadn’t, as both mealtimes and drug rounds clashed with feeding times in the NNU, when I was able to enjoy kangaroo cuddles with my boys in an attempt to forge that skin-to-skin bond.

She brought me a sandwich, knocked me out with morphine and woke me 8 hours later. My milk came in that afternoon. Her name was Dawn and I will never forget what she did for me: I felt – and feel – that she was the dawn breaking after my darkest hour.

Compromise

After that, things became a little easier. It would still be 3 weeks before I could get the twins to latch at all, and a further week before we could wean them off bottle top-ups (of expressed milk at this point). In fact, we later returned to bottle top-ups when we hit upon the compromise that was combi-feeding. On the consultant’s advice -and under the threat that my boys would be returned to the NNU if their weight gain didn’t improve – we topped the boys up at bedtime with formula, to increase their strength and allow my body the chance to recover from feeding two hungry babies all day, and on the health visitor’s advice, to give me the chance of more than 20 minutes’ continuous sleep. For me, this combination feeding was the optimum option for mine and my babies’ needs at that moment. While the romantic idea of tandem feeding two babies at once certainly manifests on occasion, if you follow on-demand feeding it is simply not the norm, at least in my experience. The majority of the time one twin is simply not interested in feeding at the crucial moment, and you end up with a sort of tag-team routine of one-on, one-off! After 4 months of that routine I sorely needed a solid hour’s sleep if I was ever going to be the mother that they deserved!

brelfie, breastfeeding, selfie, feedingAs for the nipple shields: Conall was crying for a feed at a hospital appointment one day, and I thought I’d just try him once more without to see if it would quieten him down while we waited – and he simply latched. Hal never managed to feed without his, and when my youngest was diagnosed with posterior tongue tie last year, the midwife took one look into his mouth, Hal’s mouth and my husband’s and proclaimed they all had it, which possibly explains why…

Feeding the Stigma

There’s a lot of stigma attached to the way we choose to feed our babies – and parent in general – and I think it’s such a shame. I read widely about the benefits of breastfeeding, and decided it was right for me. I wasn’t unrealistic about it – when people asked whilst pregnant about my plans (and they did – even the random elderly lady on the train!), I would answer that I hoped to breastfeed if possible. I know that some people are unable to do so, for medical reasons, and others choose not to. My choice to breastfeed is not a comment on anyone else’s choice either way. For me, it was practical – no sterilising bottles, no leaving one baby to scream whilst another feeds – and economical, the cost of buying double the formula, unthinkable. I also believe wholeheartedly in the health benefits of breastfeeding. The data is, to my mind, unequivocal. But that doesn’t mean I believe those offering formula alone are failing their babies in any way.

As parents we all do the best we can in any given moment. With the twins, combi-feeding allowed me the time and energy to actually enjoy them on occasion, to sing nursery rhymes or play with them in moments that I would otherwise have been a breastfeeding zombie. With my third (now 16 months), I have exclusively breastfed from day 1 and will continue to until he self-weans. But however you feed your babies, whatever choice you make, you should feel proud of you. If you are breastfeeding on-demand, day and night, through all those peaks and troughs and 24+ hour growth spurts – you go mama! If you are getting out of bed every 2 hours to wash and sterilise bottles and mix formula – kudos to you! I know that you, just like every parent out there, are doing the very best you can to give your baby the very best start in life. And as a fellow parent, sharing all the joys and pain of living every single day responsible for one or more wonderful-but-demanding tiny people, I say good on you. Good on us!

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