Convincing a Pregnant Mom of Twins to Breastfeed (Mom to Mom #12)
This latest question relates to the discussion we had recently about promoting breastfeeding to pregnant women.
Dear Angela,
I have a friend who is on bed rest and will probably have premature multiples. I gently asked whether she plans to breastfeed and she responded with comments about how she isn’t sure but she’s sick of strong pressure from very pro-breastfeeding women. She says she’ll commit to at least 4 weeks of “trying,” but I could already hear excuses in her explanation, such as “I’m really tiny and I don’t think my body will produce enough”, and “I’ve heard they actually don’t want you to breastfeed premies because the babies don’t get all the nutrients they need, plus they can have trouble latching on.” She also says she’s having a night-nurse and that formula will be easiest for that situation. She also constantly comments on how she hates that she’s gained weight and is worried about getting “much bigger” during her pregnancy. I do know that she wants to do what is best for her babies, and I want to help her get her past her body issues that might be keeping her from focusing on what she needs to do. Any advice on what to say to give her the best advice without seeming to pressure or judge her?
Thanks for your expertise!
Readers, please chime in and leave a comment with your thoughts on how to reassure a pregnant woman about her ability to breastfeed. Any mothers of multiples and/or premature infants out there? I’d love to hear from you on this one.
I do have several thoughts to get the discussion started. I will break this complex question down into various issues that have been raised.
Information versus Advice
It is lovely that you want the best for your friend and her babies, and I am glad that you are trying to be sensitive to her feelings. One way to help her without pressuring her or judging her is to focus on sharing information rather than advice.
While breastfeeding cannot be considered a religion, or, heaven forbid (pun intended), a cult, bear with me while I make an analogy. Which person is going to have more success: (1) the one who gives someone a cross and says “You should pray! If you’re not religious, you are subject to eternal damnation!” [”You should breastfeed! If you don’t, your babies will be sicker!”], or (2) the one who gives someone a Bible and says, “This really helped me. You might find it interesting” [”I found this parenting and breastfeeding resource to be really helpful. I thought you might like to have it”]? What about (3) the one who says, “I can’t believe you don’t plan to go to church on Sunday!” [”You’re going to formula-feed?!”] compared to (4) the one who says, “The service on Sunday is about a topic you might like. I can give you a ride if you want to join me”? [”I know you have questions about milk supply, breastfeeding twins and breastfeeding premature infants. Here’s the phone number for free breastfeeding information and support.” Or, “I attend a La Leche League meeting each month. Let me know if you want to join me!”]
Contrary to popular belief, La Leche League leaders are trained to give information rather than advice. Leaders are there to support women who want to breastfeed, not to convert women who have no desire to so. Breastfeeding is a personal decision. Giving a pregnant woman factual information empowers her with the tools to make her own informed choice. Lactation consultants are also invaluable resources for information and support (and sometimes it can be easier for women to process the information when they are paying for the service — they’ve paid their money for the information and now it’s theirs to do with as they decide).
Breastfeeding after Infertility
The question does not mention whether this pregnant mother conceived through infertility treatments or not, but as someone who experienced primary infertility, I can recognize the self-doubt that sometimes comes into play. It’s hard to trust your body to do what it is meant to do (make breast milk to feed babies) when your body “failed” you when it came to getting pregnant in the first place. Add to that a need for bed rest, and it’s no wonder this woman is worried about her body producing enough milk.
A 2007 study showed that women who use assisted reproductive technology such as IVF to conceive are less confident about their mothering skills, more anxious about caring for a newborn and less likely to be breastfeeding at three months. Such women could benefit from additional parenting information and extra support for breastfeeding.
Small Breasts Make Plenty of Milk
The size of a woman’s breasts does not matter when it comes to milk production. Milk production is simply a matter of supply and demand (the more a baby or babies suckle at the breast, the more the mother will produce). Breast size can affect milk storage capacity (but not necessarily).
Milk supply is one of the biggest concerns among breastfeeding women.
Using Formula in the Night
Given that milk production is a matter of supply and demand, any feeding during which a baby or babies receive formula is a feeding during which the breasts are not being stimulated to produce milk, which in turn lowers the mother’s milk supply. Overnight feedings are particularly important for milk production. Substituting feedings for “convenience” in the night can become a vicious cycle in which the mother’s milk supply drops and she feels the need for further supplementation. Especially in the early weeks, if a mother is not putting a baby to the breast for a feeding, she should consider pumping during that time. Pumping is not as efficient as a baby’s suckling, but it can help maintain milk supply.
Breastfeeding May Help Promote Healthy Weight Loss
The good news is that breastfeeding burns extra calories! Many, but not all, women find that breastfeeding helps contribute to post-partum weight loss.
Breastfeeding Premature Infants
It’s troubling that this pregnant mother is already hearing negative things from medical professionals about breastfeeding. Unfortunately, doctors get very little (1-2 hours) of training on breastfeeding during their medical education. Check out this piece I wrote on how to get good medical advice on breastfeeding (it also has links for other articles on where to get good breastfeeding information). There is a lot of good information out there on breastfeeding premature infants.
To ask questions or read other mothers’ stories, check out this kellymom.com breastfeeding forum on NICU babies. La Leche League also has a forum on breastfeeding premature infants.
For inspiration, read this mother’s story of breastfeeding her triplets, born at 32 weeks and 4 days (they spent 18 days in the NICU).
Breastfeeding Twins
It is a myth that breastfeeding twins is too difficult to manage. One of the wonderful parenting and breastfeeding resources out there is Mothering Multiples: Breastfeeding and Caring for Twins or More!
Kellymom.com has compiled a fantastic list of resources for breastfeeding multiples. There is also a La Leche League forum on breastfeeding multiples.
Readers, what do you think? How can this woman best support her pregnant friend? Does anyone have a story to share about breastfeeding multiples or premature infants?
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POSTED IN: Mom-to-Mom, activism, advantages of breastfeeding, breast milk, breastfeeding, how to, multiples, pregnancy, tandem nursing
17 opinions for Convincing a Pregnant Mom of Twins to Breastfeed (Mom to Mom #12)
Stacie (The Twinkies)
Mar 23, 2008 at 6:06 pm
As someone who breastfeeds twins (and did not have an easy start of it) I have a handful of thoughts on nursing twins.
It takes committment. She will be EXHAUSTED at first nursing around the clock. No one can help you (even if you pump so someone else can bottle feed you still have to, well, pump). I was obsessed with making it work. Someone who is ambivalent is going to have a hard time convincing herself to not just let someone feed a little formula so she can get a little sleep.
I’m not a big fan of glossing over either how difficult it can be at first (though all that bottle washing isn’t exactly easy either) or the benefits of BF. Someone who thinks it will be easy is more likely to quit in shock and horror when she hasn’t slept for more than 2 hours at a time in weeks.
This isn’t that coherent. Sorry. I wish her the best of luck. Once you make it through the first 3 months or so it is absolutely worth it.
Angela White, J.D., breastfeeding counselor
Mar 23, 2008 at 6:26 pm
Stacie, thanks so much for sharing your experience! It’s great to hear from a mom who made it work, especially when it was quite difficult at the beginning.
Kelley
Mar 24, 2008 at 8:08 am
So, I have a couple things to suggest. First, after reading about it here I bought myself and all my friends who have ever thought about breastfeeding the book “The ABCs of Breastfeedig.” I love this book and it’s a quick read. Her stories are great and the information current. Second, there has to be a lot of fear associated with the upcoming birth that needs to be validated and heard. Ambivalence is mainly composed of fear and unprocessed feelings. Before suggesting a LLL meeting try asking her how it feels to be her right now. I think you’ll find, if you give her enough space, someone who may be worrying if she’s going to be a good mom. My last suggestion is that you positively reinforce any pro-breastfeeding statement your friend makes like “well I’m committed to breastfeed for 4 weeks” you might add something like, “and I’ll be there to help you for that whole time.” Psychology is like martial arts for the mind… you take the path of least resistance. Oh, and one more thing… We forgot how important fathers are in breastfeeding… he has to champion the commitment and set expectations too.
As someone who never knew just how wonderful breastfeeding would be I hope that your friend stays with it!
Jill
Mar 24, 2008 at 11:52 am
What a great resource for moms or soon-to-be-moms that are dealing with anxieties of breastfeeding multiples. I love the “Information vs. Advice” section - so right on.
Gigi
Mar 28, 2008 at 6:03 pm
I breastfed premmie triplets (31w) exclusively for 6 month and then for a whole year, so it can be done. It´s not easy, it took us about 4 month to really “get it” then it was really easy (nursing-in-public easy) At the beggining you have to pump a lot, there’s no way around it, I used to nurse one per meal and pump for the other 2 because I had to suplement the breastmilk with a special powder so they´d get everything they needed, when they reached their goal weight I stopped pumping and nursed only. The thing is, it´s very hard you get very little sleep so you really really have to want to do it, but it can be done!
Angela White, J.D., breastfeeding counselor
Mar 28, 2008 at 6:06 pm
Kelley, Jill, and Gigi, thanks for your comments! I love to hear the different suggestions and especially the success stories.
Ann
Mar 28, 2008 at 7:17 pm
I’m currently nursing almost eight month old twins. I nursed them exclusively until starting solids around six months, and I’d guess it’s still their primary source of calories. It actually went pretty easily for me, but they were 39-weekers, so I wasn’t dealing with premature infants.
It’s absolutely true that your body will make enough milk if you nurse exclusively. I think I had oversupply with twins in the beginning (though I was paranoid and pumping as well as nursing, so I probably caused that myself).
Ultimately, though, I agree with Stacie that you DO need to be committed. Even when it work well, it’s intense at first (as with all new-parenthood things, I guess), and if you’re ambivalent, I imagine it’s a hell of a lot harder.
Angela White, J.D., breastfeeding counselor
Mar 28, 2008 at 7:51 pm
Hi Ann and thanks for your comment! Oversupply and low supply each come with their own set of problems, and I’m glad to hear you were able to work through the oversupply until your body regulated to just the amount your babies need!
MJ
Mar 29, 2008 at 5:21 am
Hi, as all the above comments show, breastfeeding twins/multiples is possible even if it is hard work! During my pregnancy, bf’ing was one of the things that terrified me the most, because my experience bf’ing my older child was not the best (purely on a psychological level - i felt the baby needed me too much). Strangely, with the twins, I had no problem on this psychological level.
I bf’d them until they were 6 months old, while it wasnt the perfect blissful experience some mothers describe, it was still nice and convenient. nice espec. because it allowed me to have time with each twin on his own.
What my husband and I found really helpful, was putting them on the same schedule, because it helped them have a similar sleep pattern and therefore we could sleep longer, too.
While I didn’T lose any weight from Bfing, I also didnt gain any, and once I weaned them, everything went back to where it was ‘before’.
I could have continued BFing after introducing solids, but at that point I was really looking fwd to being able to do things on my own as well!
The most important thing is for the woman to have non-judgmental support that will help her feel good about her own choices, wether she is bfing a single baby or multiple ones.
amy
Mar 30, 2008 at 8:16 am
Regarding NICU pressure to NOT breastfeed:
I had a similar experience with my daughter, now almost 4. She was 5 weeks early and small (3.5 pounds, Gestational Age of 32 weeks), but she had none of the hallmark problems preemies have, such as apnea or bleeds. In spite of her overall health, the NICU staff absolutely would not let me breastfeed her. They said it would tire her out and that would result in her staying in the NICU longer. They did, however, say that any and all milk I could pump for her was worth its weight in gold, so I did pump.
She stayed in the NICU for only 12 days, but we never did succeed in transitioning to breast once we were home. I chose to pump exclusively. Like the friend in question, I had no concrete goals when I started. I also said, “I’ll do it for a month and see what happens from there.” I ended up getting some great support from a LLL Leader and I pumped for 11.5 months. I offer this tidbit because an ambivalent goal can grow into something more solid with time - especially once the drama of preemie-ness settles down.
Best of luck to her, and kudos to her friend for recognizing her friend needs her right now.
amy
Mar 31, 2008 at 5:42 am
I used to be a board certified lactation consultant (long ago!), but I remember that we were taught our bodies make the most prolactin between the hours of midnight and 5 am (prolactin being the “milk producing hormone”) and therefore nursing in the middle of the night or pumping makes a huge difference in supply. (Is that something that his still common knowledge among lactation consultants?) So we would not encourage a mother who wishes to suceed at bfding to “sleep” throught the night in the early weeks as that could compromise her supply.
Dawn
Mar 31, 2008 at 6:44 am
I was able to breastfeed my twin boys for the first six months with no problems at all. Granted they weren’t premmie but we did have to supplement while in the hospital for a few days to get one’s weight up and despite all that I’d heard about not supplementing, it wasn’t a problem at all. The boys never had nipple confusion or any other issues. It takes commitment and determination but the body that can birth twins can also feed them. It also takes a lot of confidence. Every time my confidence would drop (are they getting enough, why is he being fussy on the breast today, etc) I found kellymom.com to be a great resource.
Cat
Apr 1, 2008 at 6:07 am
I am breastfeeding my twins of 6 months and have just started with solids. I am planning to continue untill they are a year unless they loose interest like my daughter did (at 10 months). The fact that this was not my first attempt made it a lot easier, but I do recommend getting the help of a professional lactaction consultant before the birth for a training session and immediately after. This makes a huge difference. Inspiring the dad and the woman’s mom to support and encourage breast feeding also helps.
Although my twins were born at 37 weeks, one of the boys had great difficulty latching and only really got it right after 4 weeks. Regardsless, I managed to feed simultaniously for 3 months, after which they became too big to do football hold of both. I used a very long breastfeeding cushion/ sleeper pillow. Luckely by then, they were suckling well and each of them takes only about 7 minutes to eat. My milk supply dropped at about 4 months which co-incided with returning to work. I am using Egglanol (I live in South Africa, so not sure of the brand name in the US) to boost milk production and am using a Medela pump in style brast pump to express at work. I sometimes need to supplement with formula if I do not manage to express enough at work.
My biggest inspiration to breastfeed is the knowledge that my babies will have a stronger immunity and not get sick as easily. Also as a help against allergies. I also need to stress that all 3 my kids slept through from 12 weeks (the singleton) and 10 and 11 weeks (the twins) a=on breast milk only. On sleeping patterns I will advise “Ons besomming babywize” by Gary Ezzo.
Erin
Apr 4, 2008 at 6:44 pm
My formerly preemie twins are 8 1/2 now, so I’m probably glossing over the hard parts, but I breastfed them exclusively after about 4 days of formula supping when we brought them home, and they nursed until they were 18 months old. They were 6 weeks early, and I’m an A-cup (so there goes the supply/size question). It wasn’t particularly easy at first, but not that much about having twin newborns was easy. My advice is to 1. find a good lactation consultant and make sure babies’ latches are good. 2. don’t try to feed them at the same time, especially in the first 6 weeks 3. don’t think your milk supply dries up at 6 weeks when they hit that growth spurt. Two of them hitting that mondo 6 week growth spurt is a doozy
Just know that you can do it!
Angela White, J.D., breastfeeding counselor
Apr 6, 2008 at 9:45 am
Thank you so much to everyone who has contributed a story and suggestions so far!
@Cat: I respect that moms have different ways of parenting, and I hope you understand that I have strong personal feelings against the Ezzo book you mentioned.
Those against crying-it-out might enjoy reading my very opinionated piece:
http://www.breastfeeding123.com/why-sleep-training-makes-me-want-to-cry/
Cat
Apr 6, 2008 at 10:51 pm
I have to mention that I never did the controlled crying part of “Babywize”. I just folowed the regular daily feeds and programme - never had to do the “bad” part of it. I don’t think I would have the heart to do the crying part.
Dianna
Jul 16, 2008 at 5:23 am
My twin boys are 8 weeks old, and are exclusively breastfed. I agree with one of the previous comments …. IT IS NOT EASY, but I don’t think anything with newborn multiples is! You have to be committed, as well as have an excellent support system. I’m a firm believer in the more education, the better .. I read as much as I could before the boys were born. I was determined I was going to breastfeed them, partially because people thought it was impossible.
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