preggers question re: breastfeeding

[2ontheway]

I am pregnant and hope to breastfeed both my girls, but I have a question. If all of us twin moms deliver around 2 weeks earlier on average and in some cases much earlier than moms of singletons (and I know this is on average and not a rule), how does the body know to produce milk at that point? Particularly if you have had a C-section?

I have read that there is pre-term milk that is more like colostrum, but does it come in full force like regular milk or just in small amounts like colostrum? I am concerned the hospital is going to push me to use formula.

What about when the babies stay at the hospital after you go home, if they have health problems? Will they even allow you to provide pumped milk in that situation?

[Mingle Bells]

The hormone changes that take place when you deliver (c-section or otherwise) tell your body it's time to produce milk. I have never heard of "pre-term milk". Maybe somebody else can speak to that.

Th hospital will absolutly allow you to pump and store. The NICU my boys were at were awesome about it. Thyey helped me find a pump. They provided storage bottles and a freezer in the NICU. They tube fed the boys my milk. At the begining, they did add colories to it, but it was still my milk. There is no reason they would make you go to formula. In fact, they should also encourage practice latching, if your girls are too early to be able to nurse.

Great questions! I'm so glad to hear you want to nurse :luv

[Pop Tart]

My girls were 34 weekers and it took 3 days for my full supply to come in. Once your hormone levels drop from having the baby or babies, it triggers your body to start making milk. The more you nurse/pump, the more milk you body will produce.

They will likely push for formula, especially if yours are preemies, but you can and should INSIST that you get a pump in your room and start pumping. Every little drop helps and they will feed it to them. My NICU nurses were great about helping me continue to give the girls EBM until I was given the "ok" by their doctor to nurse them for real.

Formula is not the devil, and when you're faced with 2 small babies who need to grow, its a good option. But just because they're on formula, it doesn't mean they can't still have breastmilk.

[UnFun]

My twins were born at 36 weeks and I exclusively nursed from the get go. When they were two days old, we were discharged, only to return within hours because of some issues my little girl was having. She ended up being in the NICU for two weeks. During that time she only received my milk, either directly from the source or from a bottle that I had pumped. She had some trouble gaining so they did add something to the bottles of EBM, but it was still my milk.

Also, most hospitals have a lactation consultant on staff. If you feel you need some additional help, you can request a bfing session with her. She can show you how to use the pump, and how to teach the babies to have a proper latch.

HTH!

[Iggy]

What Min said :yep

My boys were 34 weekers. I had an emergency c-section and then had to be on magnesium sulfate for 24 hours, so I wasn't able to pump or try to nurse until after I was off the mag sulf (which is awful stuff, BTW). As soon as I was off, I started, and it took another day or so for my milk to really come in.

[SnowBirdie]

congrats on your pg! :Wee :Wee

as for your body knowing to make milk, when the placenta(s) separate from your uterus hormones are released and a chemical signal released that triggers milk production, whether you are 20 weeks or 42 weeks. since no matter how you deliver your placentas will separate or be separated, that signal will be sent right on time.

colostrum will be produced first, and it is an amazing living substance. it is important they get it, and even more so if they are premature, since preemie colostrum/breastmilk is tailored specificallly to when they are born and what their needs will be. it is higher in antibodies and has the perfect balance of all nutrients for whatever gestational age your babies are born. for the first few days you will have that yellowish colostrum, and then your milk will come in anywhere from day 3-8. it will be special preemie milk, too, if they are early, and it is very important they get every drop of both they can get. it is the same living substance all babies would get from mom's milk, but tailored as always to your particular babies' needs. that is i am assuming why they called it "pre-term milk", since it does differ in some ways from the milk a mom with full term babies would make. amazing, isn't it? :cowdance

it is very important that you let your ob know you plan to bf BEFORE you go into labor, and you can request a sign to be put on their bassinets (no matter when they are born) that you are bf them and want no formula given. even if they are early and need ivs or whatever, they need your colostrum and milk, and yes, they should have a lactation consultant on staff, a lounge to pump in available for you, and freezers for bm. you will have to advocate for your babies, since they do often push formula, and if they say they need extra calories ask for bm fortifier instead of formula. if they do end up getting some formula it won't mean you can't bf, but you want them to get all your milk they can since it works on supply and demand. the more they suck the more milk you will make.

remember, these are YOUR babies, and if you want to bf you will have to make that clear, since unfortunately some hospitals aren't used to moms (especially twin moms) planning to bf and following through. as soon as they are able to take in some of your colostrum/milk through a tube into their stomachs (if they are early or have any medical issues that make it hard to feed), ask and reask the peds/nurses when you can start practicing bf. the earlier you start the better, since while they are in the hospital you can have a lactation consultant to help you get latched correctly right off.

if they tell you that you can't bf twins, that you will have to supplement, or that they are sick and need formula more than your milk, keep in mind that almost all doctors (sadly enough including peds) don't know much about bf, all the benefits of your milk and nursing itself (strengthens facial muscles used in speech development later and enhances neural pathway development when you stroke their skin as they nurse), so they may tell you that formula is fine and they need extra calories to grow, which isn't true. if you do choose to supplement, it needs to be in a way that doesn't lessen your milk supply if you do want to bf, and it can be done if you need/choose to.

i suggest reading all you can before they get here, asking if you have questions or need help, and that way you can make choices that aren't based on hearsay or misinformation. we are here if you need us or have more questions, congrats again! :hug

[Pop Tart]

I wanted to add...

Even though mine were given some formula, I still pumped every 3 hours the first month to keep my supply up (if they weren't nursing). I even was told by the LC to pump for 10 minutes AFTER they nursed to get myself to produce more. I had a TON of milk those first few weeks and once we got home, I'd use that instead of formula to help push out the jaundice.

And I still pumped, nursed, etc. I didn't know about the BM fortifier, or I would have requested that. Live and learn.

Its entirely possible to nurse twins, don't let anyone tell you any differently. Start talking to a LC now so you know your options.

[zak frost]

Mine were 37 weekers. Toad has some oral/muscular issues and probably wouldn't have been able to nurse if he wasn't a twin and if I didn't have a really strong let down reflex. Q took a day or so to figure out the nursing thing and then he was an old pro at it. Q got the milk started for Toad and then all he had to do was swallow (or drown).

[SnowBirdie]

Q got the milk started for Toad and then all he had to do was swallow (or drown).

another advantage of having a twin, right? :teehee

yes, i did leave off how important it is if they are in nicu to pump every 2-3 hours to get your supply established, especially if they can't actually nurse at first. :)

[Smidget]

mamabirdie explained it better than i could have in response to your first couple of questions. all i can say is that i had a scheduled c-section, never went into labor, and had NO problem with BFing my girls. my milk came in my first night home with the girls, so their third day. and before that, i made sure to nurse at least every three hours (with the colostrum) so that i would produce enough milk when it did come in. and i still have more than enough for the two of them.

i'm not sure if there's actual pre-term milk (i didn't read ALL of mamabirdie's answer), but i do know that your body will produce milk that is specially tailored to meet your baby's (ies) exact needs, whether they're pre-term, on time, sick, or late. and as far as the hospital pushing for formula, once i told them before my surgery that i would be exclusively breastfeeding, the word formula was NEVER mentioned to me. it was funny because i noticed the bassinet things with other babies in them (in the nursery) had formula on the shelf under it and i wondered why i didn't have any or why i didn't have the chance to refuse it. i forgot i had already told them... but, they should be pretty good about it, and i definately recommend the LC. mine practically lived in my room the first day. she was there for almost every feeding that first day or so.

and i know no hospital is gonna refuse EBM for your babies if they're in the NICU. they may need to be supplemented, but it won't be refused, it'll still be used. in fact, i'm sure they probably encourage using it, since it has so many antibodies that are important to the babies - especially when they're preemie or sick. not speaking from experience there, but just from what i know and have heard...

and last, just on a personal note, DON'T EVER LET ANYONE TELL YOU YOU CAN'T MAKE ENOUGH MILK FOR TWO!!!! YOU CAN!!! my girls are almost 7 weeks old, have never had anything else, and have both gained at least 2 1/2 pounds since leaving the hospital. So don't worry about not being able to make enough. it's definately possible. and any time you need help or advice about BF, there are some amazing women here just waiting to help! and i'll put in a word or two when i think i can help, too, lol.

[gypsymom]

Everyone pretty much covered it, but I just want to stress how important it is to stick to your guns and not be pressured by hospital staff. Even though I was pumping and have an insanely high milk production, it was one of the lactation consultants who pushed formula on my boys, along with finger feeding and nipple shields because I was having latch-on problems. This all really complicated things, and my boys haven't had any formula since we were in the hospital, but we also had an extremely difficult beginning because of all this. I'm not trying to scare you, but just want you to know that you are the one in charge. Do not let anyone else try to tell you that "most twin moms need to supplement...blah blah blah." It is NOT TRUE. There are so many wonderful women (many on this forum) who bf exclusively and/or pumped for an extended period of time. Likewise, don't feel bad if you end up formula feeding. Just do what is best for your babies and you.