June Nicholls wrote:
>1 I have been looking after twins born by C Section at 36/4 gestation they
>ar now 24 hrs old. weights 3300 and 2930.
>The breast feeding plan in place is :- Mum is Tandem feeding  15mins each
>then giving them 20 mls  Infant Formula top-ups at each feed.  Mum is able
>to hand express 10mls per breast of colostrum after each feed. When
>observing the feeds swallowing is heard.
>What would be your plan as far as pumping for this mother? Should she /
>shouldnt she?

I am no expert on twins, but in principle I would think you would not
want to be giving these babies formula top-ups, otherwise the
mother's supply will never respond adequately to eventually make
enough for two babies. Her breasts need the message that there are
twins out there to be fed - she needs to set her prolactin receptors
and supply potential to cope with this. The early days and weeks are
crucial for this.

If the babies are vigorous and capable of feeding well, why not just
let them feed often - no comps, no pumping??

>
>2. I recently read an article about engorgment management and I am sure it
>mentioned to empty both breast once while engorged, because of the risk of
>deep tissue damage to the breast?  Has anyone else read this article.  I was
>wondering if you empty the breasts  completly will the mechanism not work to
>remake more milk causing more engorgement.

I don't have the article, June, but a single complete pump-out seems
to release the engorgement and from then on the baby can keep up with
the supply. Maybe it has to do with the oedema contributing to the
engorgement, and when the milk is pumped out, this is more easily
drained away and just milk replaces the volume. Hope it is clear the
way I have explained this.
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Australian Breastfeeding Association counsellor
Perth, Western Australia.   mailto:[log in to unmask]
******************************************************************

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