When my daughter was a week old, we gave her a bottle of formula because she seemed hungry. This started a downward spiral of bottle preference, nursing strikes, low supply and ended in her weaning at 8 months. I was heartbroken. I had no idea that this could happen! Everyone told me a bottle here and there wouldn't be a big deal, but they were wrong.
My next child was nursed on demand around the clock. I never gave him a bottle or a pacifier. I didn't start solids with him until he was around 8 months old. He was the healthiest and happiest little guy you could imagine! I learned so much about what it takes to succeed at breastfeeding with him and I'm forever grateful for the lessons he taught me. I weaned him at 20 months old because I was 4 months pregnant and could not gain any weight.
Weaning my toddler turned out to be a good decision since we found out shortly afterwards that we were expecting identical twin boys. I needed to devote all my resources towards growing them as big as possible and as fast as possible.
I had my twins at 34 weeks due to many factors including IUGR and TTTS. They weighed 4 lb 15oz and 6 lb 5 oz. They went to the NICU and I went to my room to recover from the cesarean. I wanted to breastfeed as soon as possible but was not able to see and hold them until that night. I was adamant that they not be given any formula. They had IVs so that held them over until I could nurse or pump.
The next day I was given my pump and I started right away. I was excited to get a good sized quantity of colostrum. Later that day I was able to put them to the breast and see if they could latch. Preemies born before 35 weeks have problems with their suck/swallow coordination and are unable to concentrate on multiple stimuli. We were not sure if they could physically nurse. The first time we tried they were both too sleepy and just wanted to cuddly skin to skin. We could only keep them out of their boxes for 30 minutes at a time to allow them to sleep as much as they could and stay warm. Preemies can easily tire themselves out and expend more calories than they take in just by trying to nurse for too long.
So began our new routine of 30 minutes of nursing/cuddling per twin and then back to the room to pump. Every 3 hours my husband and I returned to the NICU to nurse the boys. The second time we tried nursing, the bigger twin latched on and nursed for 30 minutes! The smaller twin took more time but he began nursing shortly afterwards. My milk came in on day three and we brought 3-4 oz of pumped milk with us every time we saw the boys.
The doctors recommended topping off each nursing session with pumped milk. Little warning bells went off in my head at this idea! I didn't want to use bottles after what happened with my daughter. The NICU nurse could see my alarm and explained the recommendation to us. The boys were expending so much energy nursing and trying to stay warm that they needed some milk they wouldn't have to work for in order to gain weight. This made sense to me so we started topping them off with tiny amounts (5-10 ml) of pumped milk. My husband was awesome at bottle feeding while I was utterly incompetent so I would go back to our room and pump while he finished up with the boys.
Each day brought a new challenge. The boys got jaundiced and needed to be under the billi lights for two days, they were taken out of the warmer to see if they would maintain their temperatures (they didn't) and most of all they needed to gain weight.
I nursed and pumped every 3 hours day and night for a week and the boys passed every test. They gained weight, they maintained their temperatures overnight, and they passed the carseat test. On the eighth day we took them home! I brought a couple of gallons of pumped milk home with me as well.
At home we continued to nurse and supplement with pumped milk. I planned to nurse on demand but they were happy to stay on the same 3 hr schedule. It got exhausting to wake up at 2 in the morning to nurse and pump but we did it for an additional 5 weeks until their due date. They seemed like they were nursing as strong as a normal newborn so we phased out the supplemental bottles over the next two weeks (42 weeks GA) and they breastfed exclusively at the breast from that point onward.
They began to nurse on cue more often as well and I nursed them tandem during the day and individually at night. They sleep on either side of me and I nurse whoever wakes.
With my first two kids nursing in public made me very self conscience, but I feel like a proper lactivist now. I can and do nurse one of the twins any time, any where I go. I've met no negative reactions either. I honestly don't think most people notice that the baby is nursing!
I hope my story can encourage you to have faith in your breastfeeding abilities. If I can feed two preemie babies, surely you can meet your breastfeeding goals! I want you to face booby traps armed with confidence and knowledge. Nurse your baby as much as you can at home and when you are out. Weigh bottle feeding carefully and know the risk of bottle preference. Please don't let anyone tell you to supplement without good evidence that you need it. Get help from a lactation consultant. Join La Leche League. Determine that breastfeeding is your #1 priority and I believe you will succeed!
