Re: << I have a friend; actually he is a Youth Minister @ my church.  He and his 
wife had twins on Monday. She is a G2 P3, amazingly both babe's were vag 
deliveries. The babes (6 lbs, 38 weeks) were sent home with mom.  They are 
OF COURSE supplementing with a bottle b/c that is where our hospitals are 
now.  They don't have a clue and they all staff with RN IBCLC's. >>

Very sad, isn't it, when we have to write the word "amazingly" next to a wonderful report of full-term twins of which the first is vertex -- which occurs in more than 80% of twin sets...

I'm a RN, IBCLC in a hospital and supplementing is not based on most of us being such. At least where I am it's generally based on infant feeding behaviors (or lack thereof). So I'm wondering what kind of BF start they got -- and what mom did to prepare for bringing two BF newborns home. What was mom told re: rationale for supplementing? (BTW, supplementing does not necessarily occur under the IBCLC's watch -- and she doesn't necessarily have control over this. Other staff, pediatricians, family members, etc. often play a role.)

How did each baby BF in the hospital -- was each BF great or was one or more "sleepy" and difficut to rouse/not cueing to feed at least 8x/24 hours? Was weight loss within normal limits, did either become jaundiced, etc., etc.?

If supplementing due to ineffective BF behaviors for one/both, I'd like to assume that pumping/milk expression was initiated at that time with amount associated with babies' BF behaviors? If a hospital breast pump was used, I'd also like to assume she went home with the collection kit?

 
<< I just talked to the dad he said mom's milk was just now coming in & her 
nipples are sore.  He also shared that she had probs with 1st babe. They 
called the lactation dept @ the hospital and one of the LC's told her to 
"POWER-PUMP!"  So per suggestion she is pumping with a PNS for 10 minutes 
EVERY HOUR!  Has anyone heard of such a thing?  I encouraged her to drop 
back to every 2-3 hrs, and then pump for four-five minutes AFTER she sees 
the last of the milk in the flanges. 
 
Was I wrong? Are there LC's correctly telling moms to SUPER-PUMP? >>


Why is she pumping at all? There should be reasons for doing so! Are both babies BF -- and are signs there indicative of effective or ineffective BF for one/both? If both babies are effectively BF, they are mom's best pumps and there's no need for extra. (Exception may be for a bit of engorgement "relief" without overdoing it.) 

Why are her nipples sore -- tight related to engorgement, sign of ineffective latch (attachment at breast) and/or suckling, which in turn indicates ineffective BF behavior? Cause of situation should "drive" intervention. Also wondering what else has been advised to help resolve apparent engorgement?

What kind of problems did she have with her first baby and what about that situation relates to the current situation?

If sore nipples are associated with ineffective BF, then the use of a pump makes sense. But if babies can't yet BF effectively and we're talking around-the-clock milk expression, I'd argue in favor of a rental pump vs. PNS. 

Power pumping can be very useful in certain situations but would need to know more about the babies' BF abilities, context for pump use, cause of sore nipples, etc. first.

Karen G
(author of Mothering Multiples: Breastfeeding and Caring for Twins or More)

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