Engorgement will not go away... and other problems...

Hi!

I am a mother to twin boys, two weeks old today. I was not planning on breastfeeding due to a very unpleasant experience with it with my first DS. I had toe curling nipple pain the entire time I tried to feed him and we never figured it out.. then weaning.. then about a year of guilt. I figured I didn't need to go through that again.

However, the little voice inside my head said to give it a try this time around. So, I have. The boys were born 3 weeks early and one of them lost 20% of his body weight in the first 5 days. He actually seemed to latch well but he needed nutrients and ended up in the NICU with low blood sugar and hypothermia. The other latched well but it was super painful. I think we have worked it out and the healthier twin seems to nurse ok.

Meanwhile my LC wanted me pump for 15 minutes 8 times per day until we sorted out their latches, let them get a little bigger. Also she encouraged me to put them to the breast as much as possible. Well, needless to say there has been lots of stimulation but not too much milk removal. I have a hospital grade double pump and I know it is not removing even half of what is there. I am in an ugly cycle now of engorgement with low grade fever, which leads me to pump or hand express, which is probably leading to more engorgement.

I feel like I am starting to turn a corner in that I have a baby who can eat at the breast, seems satisfied and another that will probably figure it out if given enough time. However, I am so uncomfortable. Plus, between pumping and feeding I am getting no sleep. Plus, I've noticed that my pumped milk is more watery and I am afraid that we are never really getting to the hind milk because there is so much milk there. Add to that the nipple trauma of twins trying to feed on an engorged breast plus pumping.

I know this is complicated but I would appreciate any ideas. I am afraid to put a baby to the breast for fear they will just cause more engorgement...

Tiffany

I think the trick is to gradually reduce your pumping time, not all at once.

Also hot showers where you face the spray should help with some of the soreness. Express just enough to feel relief if you become engorged. It's a supply and demand issue. I bet when your LOs get stronger and can nurse more effectively, it will get better.

You might also try to hand express a little before they nurse to avoid them having to nurse from a round, hard ball of breast. If your nipples get too sore, try a nipple shield when necessary. You don't want your LOs to become dependent on them, but it's a good way to heal the nipples. Also use lanolin if necessary. If the pain persists, ask your doctor/LC for all purpose nipple ointment.

I would also recommend checking your LOs for tongue tied. It's common to run in families (2 of my 3 were tongue tied, as was their dad). It makes a huge difference when it is clipped. It was a painless process for my kids, no blood, no crying (they cried because they didn't like their mouth opened against their will, but the clipping did not cause any additional crying.)

:goodluck: It will get easier! This is a great thing you are doing for your twins.

I second that. But want to add that I am concerned because you said low grade fever. Does you'd LC know of the fever? Is be concerned about mastitis, personally. :-\

I second reducing pumping and hand expressing. I'll be honest, I know they tell you to pump, but I never did and I had amble supply even with one baby who had a horrible latch and one who was great.I found Brad had such a great latch that he brought my milk in for Kaylee. I'm not saying dont pump I just found it wasnt as necessary as everyone makes it out to be. To me it sounds like you have ample supply of milk. All I did if I found that they were still hungry (which was rare even in the beginning) was I'd topped them up with formula (and no there was never an nipple confusion) but I only did that for a short time. Honestly, you are going through the insanity stage right now and you need your rest. To be bfing and then pumping is so much work. You must be exhausted :(

Have you been massaging your breasts? Using heat before nursing and pumping and cold afterwards? I'm wondering about plugged milk ducts and mastitis myself.

Things are better today. My temp is coming down. I am going to see how I do with avoiding pumping during the day, only pumping at night. DH gives them a bottle at night and it is nice to have that option when I am touched out with twins. They are still full but not tight, so hopefully this is starting to get itself sorted out. Anyway, we will just take this one day at a time and see how we do. I have not told my LC about the low grade temp because it started the day after I called her and I don't want to bother her with every little thing I am dealing with. She is the LLL leader around here and basically gives out advice for free. I am just not sure if we will ever settle into a decent routine. I don't blame my breasts for being confused as to what they should be producing because as the boys get better at nursing the amount of pumping/nursing is in a state of constant flux.

Tiffany

That's what LLL leaders are there for! Don't feel guilty for letting her know what's going on. They volunteer because they want to help. :)