I would agree with all Karen Gromada has said on this issue.  I would add
that her very helpful book, "Mothering Multiples," is a wonderful resource
to have on hand.  Available at www.lalecheleague.org or through the public
library or order through any bookstore.

The biggest problem I see in working with mothers of multiples is the
unrealistic expectation that they can do this all by themselves.  It is most
important that this mother get help now, so she can focus on feeding her
babies and herself, resting, and recovering from the birth.  (A good,
nourishing diet, with iron rich foods to replace any blood loss, will help
with tiredness as well).  Then add skin-to-skin holding to help boost her
supply and babies' interest, and focusing on feeding at the breast more
frequently.  If she can learn to nurse both babies together, it will save
some time over nursing separately and then pumping.  Whenever both babies
are asleep, mother should be sleeping too, not racing around to do chores.
It may be easier to get both to nurse and sleep at the same time if they are
identical twins.  If fraternal, she can try.  If it doesn't work, let it go
rather than getting frustrated trying to wake up a sound-asleep baby to
nurse along with the other baby.  Try it again in a day or next week. Many
twin moms like the E-Z to Nurse twin pillow, which is tapered and helps
position two babies together.  (See at
http://www.Mommysthinkin.com/ez-2-nurse_twins_nursing_pillow.htm and at
http://doubleblessings.com/pillow.html   )

I agree that renting a hospital grade pump would be important until her
supply is adequate.  Were the babies near-term or early?  Did she have a
C-section that she needs to recover from as well?  Remind her that the first
six weeks is a learning period for breastfeeding, even for one full-term
baby.  Premies and multiples may need more time.  Nursing twins later on
will not be as exhausting and intense as in these early weeks.  If she can
take one day at a time, it will help.  And help her to find just one goal
she wants to reach each day (whether taking a shower, or making her bed, or
getting dressed, or walking around the block) and be proud she accomplished
it, rather than mourning the 50 things on the list in her head that she
failed to accomplish.  If she can learn to accept help now, she will have
ample opportunity to pass along the support to others in need in a few
years.  This is the very toughest time, and it will get better.

Anne Altshuler, RN, MS, IBCLC, LLL leader of a group of mothers nursing
twins and triplets in Madison, WI, mother of 5 (including 21 year old twins)

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