Hi all,
I have been working with a mother of twin boys who are now about one month
old. This mother also has a 2 year old and a 4 year old.   She developed
 sore nipples which we first thought were just positional (she was trying to
feed them simultaneously).  She also had developed mastitis.  She started
nursing them one at a time and that helped, but not as much as expected.  She
started to think that one twin was causing the problem.  I also felt that she
had thrush, and she treated her nipples and the babies for two weeks with
some improvement.  The twin in question had been difficult to keep on the
breast correctly and she had started forcing his mouth open to insure that he
didn't hurt her as much.  He has a receding chin and a fairly high palate.
 He was gaining weight fine--but was a frequent feeder, and always fussy.
 Throughout this period she resisted pumping, but did eventually begin to
pump and was giving bottles to both twins once or twice a day. She did not
think she could manage finger feeding.   To complicate matters, her nipples
are dimpled--they evert with stimulation, but then fold back in upon
themselves, and shells did not really keep them everted.  I was able to get
her dimple rings which hold the nipple out and she used those for 10 minutes
after nursing.  Her nipples are finally healing up, but she has taken
Joey--the problem twin-- totally off her breast.  She is managing to pump
while she feeds Robby, and this is working out ok.  I am encouraging her to
pursue additional help with Joey's suck and she is going to call a D.O. in
town who does Cranial Manipulation.
She is concerned about continuing to breastfeed one twin while bottle feeding
the other.  She is a very loving mother, who holds her babies, etc.  If we
cannot get Joey back on her breast, she is considering weaning both of them
because she is afraid of how her relationship would be affected.  She does
say that Joey is much happier with bottles.  I was fearing breast aversion
with him, being forced on like she had to do to avoid more trauma.

Does anyone have an opinion on this?  I told her that although I have read
somewhere (I can't remember where)  that it does affect bonding--can that be
avoided in a consciencious mother, or is it inevitable?
Does anyone have experience with this or know of any research?

Thanks,
Chris Lundberg, RN, IBCLC
Indianapolis, IN