Struggling to feed twins

[nightowl46]

Twins born at 35 weeks, now 6 weeks old. I had massive (4L) blood loss in C section. Then again at 3 weeks I had more bleeding and had a D and C, and mastitis at the same time so supply really fell. Now I have my second round of mastitis.

Baby A has slight lip tie. But transferred 98mL of milk at lactation appt. He weighs 8 lbs and eats about 90mL per feed.

Baby B has bad reflux and eats less (weighs 5.5 lbs and eats 60mL per feed). She transferred 72mL at lactation appt.

So after the appt we decided I’d BF baby A during the day and baby B just 1-2 times per day so we can fortify her milk in bottles to help thicken it + give extra calories. The problem is baby A will nurse for like an hour and be unsatisfied. I’ve nursed him for an hour and then he’ll take a bottle of 70mL-90mL after. He’s also bit the crap out of my nipple so now it’s extremely painful to BF on the right side.

Me: I have nipple vasospasms. Also pumping isn’t working (my R boob currently engorged but only able to pump 20mL after 20 min with Medela Symphony pump, not emptying my breast at all). Only the babies will empty my breast. But I don’t seem to be making enough milk for them / pumping isn’t working.

I’m exhausted so hopefully that made sense. I’m ready to give up but don’t really want to because technically they can both latch and transfer as evidenced by my lactation visit. (At the visit, babies hadn’t eaten for four hours nor had I emptied my breasts for that long, hence the “success”?).

Please help me, thank you. I just am at a loss for what exactly I should do. Tried different flange sizes, I like my lactation person but her only advice re: pumping was to relax.

 

[soxaholic55]

@nightowl46 Kudos to you for feeding twins. Most of us find the learning curve to feed one extremely challenging let alone two. You’re doing a great job. Even though you said you had gone 4 hours before the weighted feed those are excellent numbers and indicative that you do have adequate milk supply (did they unlatch on their own? It’s possible they didn’t even fully empty you) and that they can transfer milk effectively which is huge for maintaining supply. I have a couple thoughts.
1. Check out this info about why a baby might take a bottle after nursing. I feel it applies to baby A. Since he seems to be doing really well have you considered offering him a pacifier after a feed? Maybe that would help him get off the breast when he’s comfort nursing and it will satisfy his suck reflex.
2. I think you’re doing the right thing right now with baby B, nursing her is important so she still is comfortable latching. But giving her bottles to help her weight gain is best while she gets stronger and you get her reflux under control. I would consider a different pump. Many women respond better to a simple hand pump. Other women need a more powerful pump such as the Spectra S1 or S2. If either of those is an option for you I’d try that. Or, your hospital may be able to rent out a hospital grade pump as an alternative. I think it’s worth exploring to see if you have any changes in output from another pump.
3. I think what your LC should have said instead of “relax” is to try your best to take really good care of yourself. If you have a partner or other support people who can do all the other things (diaper changes, cooking, cleaning etc) it would be really helpful. You need time to be with your babies, skin to skin with minimal other distractions. Eat as much as you can, lots of protein and healthy fats. Stay hydrated. It will make you feel better and your body won’t be totally depleting you trying to keep up with your babies’ needs.

Ultimately, keep track of diaper output for both babies at home. That’s your main indicator for good supply. I would probably continue to do weekly or biweekly weighted feeds and try to have them done max 2-3 hours after the start of the last feed.

Wishing you the best of luck. You got this!!