Hi Kathy,
Well, I see where you said mom's main concern is the plugs, but mine would
be the slow wt gains, and what would appear to be poor breast emptying, now
low supply or low production.
As far as the plugged ducts, I am thinking ineffective breast emptying that
probably started in the first days, due to possibly prematurity (you didn't
say their gestational ages, although they were of good birthweights),
ineffective feeds due to respiratory issues for one or both (requiring
oxygen), late use of a pump when possibly it was indicated early on,
restricted tongue mobility of one or both twins and possibly learned
ineffective sucking patterns.
The main thing I think I would recommend would be a regular milk expression
routine with a top notch hospital grade pump. This would help her plugs,
help her supply, and help her babies to get more breastmilk. I would start
here, and see if they can work towards more breastfeeding.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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