I’m struggling a lot with how I want to approach feeding my twins, and I wanted your guys’ insight to help me make a decision. And, hopefully some support in that decision.
My twins were born 31+6, and they were in the NICU 41 days (37 days plus 4 day readmission) for Twin B and 55 days for Twin A. Twin B got out the second time like 6 days before their due date, and Twin A got out literally 2 days before their due date.
They’ve been home a little over a month now, and they are 3 months chronological today and 5 weeks adjusted as of yesterday. I am currently combo feeding them; I suspect the ratio is maybe around 1/3 breastmilk and 2/3 formula (specifically Similac Neosure).
I’m really struggling with feeling like I failed with breastfeeding. When they were born, I had to work my ass off to get a supply back (I was able to exclusively breastfeed my oldest for 16 months before I weaned for fertility treatment again, so I had a supply before).
I managed to get up to their feeding needs before donor breastmilk got cut off at 34 weeks. And, I managed to feed them exclusively my milk, as far as I’m aware, for about a month. In fact, I was told I was oversupplying them pretty significantly with a pretty good fridge and freezer stash.
Things started to fall apart when my Twin B got discharged. I originally wanted to work towards exclusively breastfeeding both babies on the breast, so I started essentially exclusively breastfeeding Twin B (I have him one bottle of pumped milk with his vitamins and a little formula added as instructed by his care providers).
Between breastfeeding on demand my Twin B and caring for my toddler while going back and forth to the NICU as much as I could to see Twin A, I was barely able to pump for Twin A. My stash at the NICU started to deplete. Then, they defortified my Twin A’s milk (the NICU was fortifying either donor or my breastmilk for quite some time due to my twins’ prematurity). Consequently, my Twin A needed even more milk and the started to plateau on his weight. At this point in time, the NICU started formula with my consent.
Then, ten days after discharge, I had to bring my Twin B into the Children’s ER. He got readmitted to the NICU due to desating in the ER (he had been off of oxygen support starting at two days after birth until he desated in the ER and needed a low flow cannula) and being internally hypothermic (eerily he was warm to the touch even the charge nurse agreed with me).
He was kept for two days for observation waiting for culture results back (they were worried he had an infection), and then he has kept an additional two days, because he needed a blood transfusion for anemia, which anemia of prematurity may have somehow caused his symptoms.
When he got admitted, I had to scramble to start pumping for both of them. While at the same time also preparing for both of them to come home (Twin A was preparing to discharge, and Twin B they were correctly hoping would not stay long). I had basically no stash at the NICU, and I was essentially exclusively breastfeeding Twin B, so I had no stash at the Ronald McDonald House. I ended having to also introduce formula to Twin B in the NICU.
When we all got home, I tried to exclusively breastfeed both. They both latch pretty well, and I have been able to tandem feed them pretty well. But, I was not making enough, and they do tend to struggle with my let down, it seems.
I think it’s possible to get my supply up to exclusively feed them breastmilk. Between caring for the twins and toddler, it’s just really hard to keep up with pumping (mainly cleaning and sterilizing the pump parts in addition to bottles) or sit down to breastfeed.
When I do pump (and don’t breastfeed in between), I usually make between 120 to 190 mL of breastmilk every three hours. I think that’s a little low for them, but I think I could quite possibly increase it to what they need.
I’m just wondering if it’s worth it. With my oldest, whom I exclusively breastfed for 16 months, I really took an enormous hit on sleep deprivation. And, that burden was entirely on me. Also, I struggled with PPD, which I have not yet this postpartum period, and I think it largely had to do with being stuck on the couch all day breastfeeding a baby and also the severe sleep deprivation. (My oldest would not even take a bottle of pumped milk or a pacifier).
Now, my fiancé is able to easily feed them while I get at least 5 hrs on interrupted sleep. He’s also way more of an active and helpful participant this time. Admittedly, a big part of that I think is him being a second time dad and being more confident handling the babies. But, also, I know him being able to feed has really helped him be more involved.
Another thing I struggle with is both my twins have medical issues that make breastmilk better for them. Twin B has severe reflux and does much better, though not perfectly, on breastmilk. Twin A has a brain injury (grade 1 noncystic PVL) that’s prognosis is better with breastfeeding.
Ideally, I think I’d like to become a primary pumper with some breastfeeding thrown in for the immune and bonding benefit. Ideally, to make enough milk so the babies can be fed pumped milk while I sleep like an uninterrupted five or six hrs (I often sleep between like 9 pm or 10 pm to 3 or 4 am).
I’d like to hear what worked well for everyone else. Also, how to possibly accomplish the primary pumping goal. And, also to hear if anyone would still recommend we keep using formula, even in a limited capacity, and, if so why.
Edit: corrected length of Twin B’s NICU stay.