Hi Jannette ~

You are NOT running out of options and you want to stay calm so this new MOT
and DOT do too! And it is not your fault that "too many visitors" for the
last 2 weeks interfered with BF - argh! Don't let the pressure of Dad's
return to work let anyone get overly concerned.

You did not mention the gestational age of these babies at birth - very
important since twins are often early and it helps to calculate the current
gestational age. Their chronological age also wasn't clearly stated. It
would also help to know each baby's birth weight and their current weights.

In addition to finger-feeding, you mention they are being bottle-fed but
didn't mention the brand. I'm not encouraging mentioning that on an
international list, but only a few types labeled as "slow flow" actually are
slow flow. The fact that the bottles are being pulled out with 10-12 sucks
indicate the nipple is too fast flow -- but I should ask what
(each/individual) infant cues indicate the need to intervene after 10-12
sucks. (Pulling a nipple out, especially so often, can contribute to infant
oral disorganization. Depending on how positioned upright, oral
disorganization is less likely to occur if baby - with bottle in mouth - is
tilted forward toward prone while held supportively or, with the bottle
still in the mouth, it can be tilted to the corner of baby's mouth.)  Fast
flow "forces" a baby to adapt oral behaviors in order to breathe -- a baby
must breathe less when flow is faster. Faster flow results in the need for
increased swallows and swallowing competes with breathing (no matter how
mature one is). Kind of difficult to figure out the breast once used to
(mal)adapting for fast flow. Another LC and I tested a bunch of bottle
nipples for flow rate using a breast pump. If interested in results, email
privately.

With twins it is important to assess each separately. It's unusual - even
for monozygotic (identical) twins - for each to demo the exact same feeding
behaviors, although parents and caregivers often find it difficult not to
"lump" them together even though everyone knows they are separate persons.
One is often ready to make a move/improve before the other(s).

Glad lots of skin-to-skin is part of the picture. Is each baby getting
opportunities to find the breast on her own just before an anticipated
feeding time via being placed skin2skin between mom's breasts (without bra)?
How often is this being used?

Has a thin silicone, appropriately sized nipple shield been tried? (And is
it within reach if one baby "seeks" the breast but has difficulty getting a
good latch? And does could a few drops of EBM be available to place inside
and outside on the shield to encourage sucking?)  And if so, recently? And
if so, was Mom given good instructions on its use - getting it on "deeply"
enough? Often a mom tried a shield days or weeks ago and, if it didn't seem
to work, she thinks that's the end of using a shield. But each baby changes
- what didn't work before, may work terrifically now; what worked before,
may not work as well now. Gotta keep trying and need flexibility with twins.

Where have all the guests who inundated these new parents for 2 weeks gone
to? She needs help when her husband goes back to work. No matter how these
babies are fed, it is UNREALISTIC to think someone with twice the usual
number of new babies can care for both without some extra help - while also
transitioning 2 babies to breast, pumping enough so that production doesn't
drop (with Dad gone more), bottle - and finger-feeding, etc, etc, etc. Help
this MOT find help! Family, friends, postpartum doula, etc.

Many MOT have dealt with situations similar to this MOT's - her situation is
pretty common after twin birth - and have achieved effective BF. It is worth
hanging in and her babies can get there, unless there's some underlying
physical issue affecting one/both (more unusual). However, the BF "progress"
plan has to be realistic for the situation of 2 babies, milk production
needs to be protected, and the parents need to realize it is OK to need help
for awhile.

Glad they have you to provide support and info! This MOT may also be
interested in the Yahoo group APMultiples, which has many, many MOT who've
been through exactly what she's going through. (Go to first link under Links
at my web site.) Also, there's now a Mothering Multiples page on Facebook,
and she could ask questions under the Discussion tab.


Karen Gromada
(for context re: above - author, Mothering Multiples: Breastfeeding and
Caring for Twins or More)
www.karengromada.com/



> Date:    Sun, 11 Apr 2010 02:08:30 -0400
> From:    Jannette Festival <[log in to unmask]>
> Subject: Breast Feeding Twins-not latching
>
> I'm running out of options! I have a mom who has not BF her twins for 2 w=
> eeks due to too many visitors, babies getting their first bottle in NICU =
> (1 hr old). She has called me and asked for help. When mom puts babies to=
>  the breast they gag and push her nipple out (mom also lets the babies us=
> e soothers). She is bottle feeding breast milk (yeah!). Mom and Dad are d=
> oing lots and lots of skin-to-skin, finger feeding (with a finger tube) t=
> o help baby get used to having to work for their food. Now they are being=
>  fed in an upright position with the bottle parallel to the floor-pulling=
>  bottle out of their mouths after 10-12 sucks to slow the overall pace of=
>  getting fed. Our next plan is to try and feed while having a bath...then=
>  what? Mom is doing all the right things to get babies to latch, but it's=
>  almost like they don't get it and just want the original bottle back. It=
> 's like the old saying...You can lead a horse to water but can't make the=
> m drink it! I'm at a loss for the next step. Has anyone else run into thi=
> s before. Having 2 babies will be difficult ...dad is going back to work =
> in a few days so mom will be on her own. BF at the breast would be so eas=
> y...if they only would!
>
>             ***********************************************
>
>

             ***********************************************

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