Jan,
A number of years ago (6) we had a mother attend our La Leche League group
meetings for mothers nursing twins.  This mom had a three year old when her
twins were born prematurely.  Within 24 hours of their birth, the mother
suffered a stroke.  She was unable to use her left arm or leg for several
months, and had pain as an additional factor to deal with.  The babies were
small and were given formula feedings in the Special Care Nursery. The
doctor also insisted that the smaller baby not be put to breast until she
reached 7 lbs! This took a month.  The other baby nursed from near the
start.  This mother went on to get the smaller baby from totally bottlefed
to breast and ended up fully nursing both her twins for over a year, I
think.  She received PT and OT visits several times a week at home, and
eventually regained full use of her affected arm and leg.  The
longest-lasting deficit was in her speech, and for over a year she had
trouble with remembering words. (Especially distressing to her, as she was
a professional singer.)  This mom succeeded through sheer determination,
having plenty of help from a supportive family, and patiently working with
the smaller baby to teach her to latch on to the breast and work for her
milk.  In this case, having one twin nursing proficiently helped to keep up
the mother's milk supply while the other baby learned. This mother moved
away at the end of that year, and I've lost contact with her.  She did
enjoy coming to our monthly meetings and getting peer support,
encouragement and praise from the other mothers nursing twins.  In addition
to her special challenges, she struggled with all the issues they had in
common, such as getting enough sleep at night when the babies had different
sleep schedules, the needs of a three-year old with twin baby siblings,
etc.  I think the chance to share was important in decreasing her sense of
isolation.

I know many more ways to help now than I did then.  The main thing, though,
is that if a mother truly wants to breastfeed, she can overcome many
obstacles.  I think that with your help, a good breast pump if it is needed
at the start, plently of pillows, and household breastfeeding-friendly
help, she can make it.  A lot will depend on seeing what works best for her
for positioning and baby care, and being flexible.  Also, working to
conserve her energy and rest.

Anne Altshuler, RN, MS, IBCLC and LLL leader in Madison, WI
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