> Here goes... twins born 33 wks, now 10 wks. Gaining slowly but
>moderately - were 4.11 and 5.11 at discharge, been home 6 weeks and are now
>over 7lbs and over 8lbs (Mom doesn't know exactly, she's so stressed out).
>Single older Mom, no support -- lives with her mother and brother who refuse
>to help AT ALL!!
> LC tells me babies are 60% supplemented getting about 14 ounces per
>day (mom didn't know herself). Babies were very fussy when we arrived, over
>the three hours we had the babies nursing very well for 10-15 min. stretches
>broken by 20 min or so naps the entire time. The smaller one needed to be
>latched on most and more frequently, larger twin fed once or twice and then
>slept soundly.
What sort of output do these babies have? Is the supply actually that bad?
Is something else bothering them? Everyone (except us, that is) just
assumes that babies are hungry if they are unsettled, but it could be
something else.
> I suggested one thing she could try is a 24 hour nurse-a-thon -- NO
>supplements, in order to up her milk supply and get the babies off the
>bottles. Mom reports that babies will refuse bottles and cry hysterically if
>given bottles after breastfeeds. She reports same is true if she gives
>bottles first and then tries breast.
This sort of indicates that they are not still hungry after feeds of either
breast or bottle.
Mom is going nuts and thinks she is
>harming the babies by going back and forth. Wants to do one or the other,
>cannot take both any longer. Hence my suggestion. Mom has been told she
>doesn't have enough milk to feed two babies right now bc of the supplements
>and therefore sees formula as her only option.
> LC is adament that she CANNOT do a 24 hour no supplement breast only
>bc "you cannot go cold turkey from60% supplementation"
> My question is: WHY NOT? won't a nursing fest especially with twins
>up her supply but quick????
If she truly does have insufficient milk, then it will take a few days for
her supply to respond, so going cold turkey may not provide enough straight
away. She may be better off doing a 'nurse-a-thon' all day long and then
give as much formula as they need in the evening, so she can get some rest
and ensure that they will get enough overall. (Or she may find she has to
start with two formula feeds per day - depends how low her supply is
relative to the needs of the two babies.) Doing this for a few days
hopefully would result in the need for less and less formula each
successive evening, until she can cut it out altogether.
> How would the mother know if they weren't getting
>enough? would there be fewer diapers in a mere 24 hours?
Yes, wet ones would decrease and if babies were a bit dehydrated the urine
would be coloured and more smelly. I think this would happen fairly quickly.
(I'm thinking
>crying would be an indicator - but if they eat well by signs of swallowing,
>etc and then fall asleep, and nurse again 30 minutes later so what?!)
> How would one tell after that 24 period whether or
>not and by how much to supplement?
Would have to 'play it by ear' I guess. If mum not getting any sleep, then
a bottle might be a useful compromise. Mum has to function too.
> Mom has NO support and NO transporation so getting to an accurate
>scale is next to impossible... but could be worked out maybe?
I would rather just go by output and general behaviour of the babies and
not get mum too stressed out with weights every feed. Weight should still
be monitored of course, but only every few days or week. As long as they
are peeing and pooping, they are not going to starve in a few days. Could
someone go and visit her, weigh babies and give her support and
encouragement every few days?
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Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia. mailto:[log in to unmask]
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