It has been a twin week here, I saw my second set this week.  The twins
I saw yesterday are NICU graduates, the hospital LC did a great job.
Both babies are fully breastfed, gaining weight and doing well.
Mom feeds babies at the same time with a pillow and this is going well.
The problem is the pump, the hospital sent it home with her and told her
to pump for 15 minutes after every feed on high suction.  After she
feeds the babies her nipples are fine, after the pump her nipples hurt,
plus the pump noise is giving her headaches that are pretty bad.  She is
pumping close to 80 cc's after every feed and already has bottles piling
up in the freezer after a few days at home.  She eliminated the night
pumpings on her own at home and has some engorgment in the early am, she
called about this and they told her to pump before the am feeding and to
use warm compresses.
All my information advises against using the high suction, I don't know
if the mom misunderstood this or not, so we talked about cutting down on
the suction to see if that helped with the nipple soreness.  I didn't
want to contradict the hospital who had clearly done a great job with
initiating breastfeeding for these babies, but wonder if she needs to
continue to pump that agressively with both infants fully feeding and
gaining at the breast.  I basically told her that they were her infants
and she needed to do what worked for the family.  We talked about first
feeding the babies, second feeding the mom and third lots of rest and
letting everything else go.  I will be seeing this family again soon and
would like to know if I have missed something that I have not learned
about pumps and feeding twins.
I did do a literature search on Lactnet and several other places before
I went to visit. Sorry this is so long, just after the reminder to keep
things concise.
Pat Thomas PHN
Winona County Community Health Department
Winona, Minnesota

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