I suspected (and still do)
>that her supply is fine, (she is nursing both twins every hour-two during
>the day and every 2 hours at night.)

I agree that it is probably a management problem and not insufficient milk.

>but that he babies are just fussy as is characteristic in the evening of so
>many babies.

Certainly, this could be the cause of the fussy evenings, as could a food
sensitivity (dairy, of course, especially since the formula was introduced
at that early age) which presents with fussiness in the evening.

she felt certain they were still hungry, since they are
>drinking 3-4 ounces of formula after nursing for 1-2 hours.

A baby who is uncomfortable in his stomach and intestines will always
overfeed with a bottle because of the need to suckle to relive the
distress.  It is NOT  a sign of hunger for a gassy baby to scarf down 3-4
ounces from a bottle after feeding for a long time at the breast.


I suggested
>that maybe it is more of a let-down problem, rather than a suppply problem,

It could be a let-down problem at this time of day.  I'll bet "sleep when
the babies sleep" is not in her daily program.  I recommend Rescue Remedy
with my clients who have let-down problems.  It quickly facilitates a
let-down, even in the most dire cases. Are you familiar with Rescue Remedy?
 I had a similar case last year--4 year old, 2 year old, then twins-- and
mom found that RR helped in many ways during the early weeks of adjustment.

  We talked about her husband taking the twins out for
>a stroll, or somehow changing their environment, to seee if the become
>contented without more food (after nursing).

He would do well to take the older children somewhere, preferably with him
to the deli to get supper.  The mom whom I mentioned had a hubby who took
charge of dinner for a while--sometimes cooking, sometimes bringing in
dinner. He could at least play with the older children for a while so that
mom can have a relaxed (?) feeding with her little ones.

>toward the end, she mentioned that they are "constipated".  I am not clear
>on whether this is true constipation (hard, dry, painful), or just
>infrequent stooling (but hte babies are only three weeks old, so this too
>would be a concern).  She said the often skip several days between bowel
>movements.

I have seen "constipation" frequently with breasfed babies who are
supplemented with formula. It is poor digestion.  And it could contribute
to their fussiness in the evening, by setting up an irritated system.  The
bad part is that babies will usually go to sleep after the formula and look
peaceful, giving everyone a break from their demands.  That is until they
develop full blown allergies, reacting to everything.  This formula is
probably the culprit all round and the pediatrician should be strung up for
his anti-health suggestion in the first place!

>She started giving (her husband did actually) one bottle of formula in the
>middle of the night at 3 days old, on her pediatrician's advice (ostensibly
>to prevent premature weaning because of exhaustion).

ARRRRRGGGGGHHH!!  And now he says that she doesn't have enough milk.  From
the beginning he probably thought that she couldn't make enough milk.  It
makes one wonder why these guys are called doctors FOR the children.

I think that your recommendations are right on.  She needs to feed the
babies in the evening or soon she *won't* have much at that time of day.
Frequent feeding in the evening will build up her supply if it has been
compromised.  She could take Rescue Remedy throughout the day--4 drops in
everything she drinks--and 4 drops under her tongue at this stressful
evening time.

And it would be good if she got some kind of help in the late afternoon and
evening.  If her husband cannot be of help (except to further undermine her
supply) they could hire some kids to come play with her older children. if
the Ped was soundly trained in breastfeeding and believed in the necessity
of exclusive breastfeeding, he would have suggested to Dad long ago that
support measures be in place, instead of selling formula again.

Mothers like this need so much support and there are few people out there
who will give it to them, particularly the people who "run things."

Good luck to you in your support of this mom.  If you want further info. on
RR, let me know.

Pat Gima



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