Tina wrote, "To all those of you who are specifically "against" moms giving
each of two very different sized babies their own breast-- please educate me"

Others have mentioned many of the advantages of changing "sides" while
breastfeeding twins and I must say I would really hesitate to advise any
mom to unilaterally breastfeed right from birth, even if she had twins and
thus two chances to do so simultaneously.  As others have also related, I
started out breastfeeding my identical boys (surprise twins, born 5 days
before due date by elective C/sec, weighing 2520g and 2720g - yes, this
*happened*!) while alternating breasts for each feed, then eventually
settled for alternating breasts each day, because it seemed so much easier
to remember.  I was lucky and found that simultaneous nursing was possible
after about the 4th day, and saved hours of time.  I also came to realize
that the bigger/stronger baby would stimulate a good let-down for the
smaller/weaker baby to benefit from, thereby obtaining more milk than he
would have generated by himself.  In addition, alternating breasts also has
the effect that the stronger baby will drain, say the left breast really
well on Monday, and the right breast really well on Tuesday, and thereby
keep both breasts producing a lot of milk.  By keeping a smaller/weaker
baby on one breast only, reduced drainage over time would cause the milk
supply in that breast to down-regulate, so that the smaller baby would
obtain even less, and even less a few days later .... Whereas in fact
(particularly in the case of twins with widely discordant weights, as often
happens with identicals in utero, the smaller one in effect being SGA, as
Karen mentioned) the smaller baby needs *more* milk per kilo than the
bigger baby does, in order to achieve a catch-up gain.  And ordinary,
as-it-comes breastmilk will achieve this, without the need for
lacto-engineering, as long as the baby gets enough of it ....

But quite apart from milk intake, one of the reasons I haven't seen
mentioned is the need for each baby to have stimulation to both sides of
the face, and for alternate hands to be free while breastfeeding.  At the
age of 10 months, my smaller, more placid baby suddenly went on strike.  In
the course of coaxing him back to the breast I found that he preferred the
right breast (which incidentally produced a bit more milk and was "easier")
so I let him have the right breast as his exclusively thereafter.  My
babies nursed for a very long time - "officially" weaning at age 4, but
occasionally nursing until they were 6.5 years.  Once they were able to sit
up I changed from nursing them mostly in the football hold, to having one
sit on my lap and the other sitting next to me, and they'd play or drive
dinkie-cars up and down my chest and so on while still staying plugged
in.  When they were 4 they went for an exhaustive developmental check
during which it was found that the twin who had exclusively nursed for the
last 3 years on the left breast (with his left hand free) was left-handed,
and the twin who had gone on strike and then received the right breast
(with his right hand free) was right-handed.  Mirror twins?  No.  Both boys
had dominant right feet, and dominant right eyes - only the handedness was
different.

It was only when I started doing a lot of reading for the IBLCE exam that I
learned that stimulation to both sides of the face/hands is needed and that
the different handedness of my boys had probably been environmentally
*caused* by the unilateral breastfeeding rather than being
hereditary.  Consequently I now teach that babies who are only feeding from
one breast need their position in relation to the mother's body to be
changed around (Madonna/Football) and that includes twins.

IMHO increased breastmilk intake and bilateral stimulation for each baby
are both achieved by alternating breasts when breastfeeding twins.

I hope this persuades you Tina?  Thank you to Karen for wonderful posts on
breastfeeding twins and more.

Pamela Morrison IBCLC
Harare, Zimbabwe
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