Need advice!

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bamsmom's picture
Joined: 05/05/07
Posts: 1635
Need advice!

Hi, I'm Erin Mommy to 8 days old twin girls (35 wkers). I have had successful breastfeeding relationships with my 3 other children and full intend to this time as well, but we are having some issues. The girls are not gaining weight. Leah was born @ 7.7 and is now at 6.4 and Jocelyn was 6.10 and is now 6.2. We used the SNS system while in the hospital and I continued until my milk came in which was early Monday AM. Leah was readmitted Monday for jaundice, but is doing well now. So we went back to the ped today and Leah had lost more wt and Jocelyn had only gained 1oz since monday and he wants me to supplement. I prefer not to, but at this point Leah has lost so much wt I dont think I have a choice. So here is my question. Would you breastfeed and then give them an oz or 2 of formula by bottle OR should I try and use the SNS system again and if I do that should I BF 1st and then incorparate the SNS (so putting to the breast twice) or is it ok to bf and use the SNS @ the same time (just putting them to the breast once)? Oh and I broke out the pump so I am going to try a pump after the girls feed, but only during the day.

I want to add too that they are good nursers. So I'm just not sure what to do here...Thx!!

TiggersMommy's picture
Joined: 02/14/10
Posts: 6043

Congrats on your twins! Since they're both nursing well and your milk is in, I don't really see the benefit in using the SNS. They'll fill up before they've stimulated your breast enough to keep up with their demand. Have you seen a lactation consultant? I suspect that your supply just needs a few more days to build up to the demand of twins. At just 8 days old they don't need much per session since their little bellies are so small but you pretty much have to double that since there's two. That might explain the weight loss but I can't be sure as I have no experience nursing twins. They were born at a good weight and losing ~1 lb doesn't sound like an emergency to me. I'd suggest to just keep plugging away. Ditch the SNS and nurse as much as you can and maybe pump after they're both done to boost your supply even more. I know there's a few moms with twins that frequent this board so I hope they'll give you better advice.

Congrats again!!!!

tink9702's picture
Joined: 09/28/08
Posts: 2977

Congratulations on your twins!

How often are they nursing? Maybe you should just nurse more often? Do you have enough help with the older children to take the twins to bed and nurse and just focus on the babies?

Also, if your milk only came in 48 hours ago it might just take a couple more days before they start gaining more?

I would definitly nurse first then supplement with formula if you feel they really do need it. that way your supply will continue to increase.

VCoates's picture
Joined: 05/22/07
Posts: 1055

I don't think there is a reason to supplement. I was told by both my pedi and the LC that they allow a 10% weight loss. According to what they've lost, Leah has lost just over 10% and Jocelyn hasn't reached that 10%.

I think you should give it a few more days now that your milk has come in and see how that goes.

Like the PP, if you're dead set on supplementing with something, I'd offer bottle after they've nursed but I wouldn't use the SNS.

carg0612's picture
Joined: 09/23/09
Posts: 1554

I agree with pp. If you feel they need more then nurse first and supplement afterwards.

Congrats on your beautiful twins!!! I hope they'll start gaining for you quickly.

I would also recommend seeing a LC - totally worth it.

Cherrykitten's picture
Joined: 07/03/08
Posts: 700

Jocelyn sounds like she is on track and should keep gaining. her weight loss was average and it can take up to 14 days for baby to regain birth weight. It's Leah that worries me a bit, especially with being readmitted. when does the dr want you back for a weight check? As a standard in lacation we see 10% weightloss as a serious redflag and her weights that you listed from discharge are roughly 15% weightloss. What is her current weight?

My suggestions based on the info would be to:

Contact the dr about having weight checks more often for both girls or buy a home scale to keep up on it yourself.

definatly supplement leah but put her to breast first and follow up with supplementation. It doesn't sound like you have an issue with supply so using the SNS wouldn't be necessary. using paced feedings with a bottle would probably be your best bet.

Supplementing jocelyn would be your own decision based on the conversation with your doc.

Reach out to a LC either at the hopsital you delivered at or a private LC that can visit you at home. Having someone there that can see what is really going on can give you the best possible help to get both girls back on track!

bamsmom's picture
Joined: 05/05/07
Posts: 1635

"Cherrykitten" wrote:

Jocelyn sounds like she is on track and should keep gaining. her weight loss was average and it can take up to 14 days for baby to regain birth weight. It's Leah that worries me a bit, especially with being readmitted. when does the dr want you back for a weight check? As a standard in lacation we see 10% weightloss as a serious redflag and her weights that you listed from discharge are roughly 15% weightloss. What is her current weight?

My suggestions based on the info would be to:

Contact the dr about having weight checks more often for both girls or buy a home scale to keep up on it yourself.

definatly supplement leah but put her to breast first and follow up with supplementation. It doesn't sound like you have an issue with supply so using the SNS wouldn't be necessary. using paced feedings with a bottle would probably be your best bet.

Supplementing jocelyn would be your own decision based on the conversation with your doc.

Reach out to a LC either at the hopsital you delivered at or a private LC that can visit you at home. Having someone there that can see what is really going on can give you the best possible help to get both girls back on track!

So we are rechecking their wts tomorrow. Leah's wt on Wed was 6.4. I have been putting her to the breast and then following up with 1 oz of formula. Jocelyn, I am supplementing every other feed, just 1 oz. I hope that this helps, I hate being under the magnifying glass!

emansmom's picture
Joined: 03/24/09
Posts: 752

I just want to say you are doing an awesome job!! It must be hard feeling like you are being watched and have to be so careful but I am sure in the next week they are going to be growing like weeds and you will be able to stop supplementing. You just have to get passed this hurdle and you will be golden! Keep it up momma!

Cherrykitten's picture
Joined: 07/03/08
Posts: 700

"bamsmom" wrote:

So we are rechecking their wts tomorrow. Leah's wt on Wed was 6.4. I have been putting her to the breast and then following up with 1 oz of formula. Jocelyn, I am supplementing every other feed, just 1 oz. I hope that this helps, I hate being under the magnifying glass!

I know it's hard :bigarmhug: sounds like you're doing a great job and the weights should stablilize well with what you're doing. And sorry if I sound really "clinical" sometimes....it's hard to ask questions on the computer and still get my personality across Smile

mommycarrie's picture
Joined: 09/07/06
Posts: 358

Just wanted to say great job. It sounds like you've got your hands full and it seems like you're doing wonderfully. Hang in there.

:kaos3: :kaos3: :kaos3:

Joined: 01/25/02
Posts: 2023

Erin, I am sorry I missed this. I lost my brother last week... so I have not been here. Anyhow.. how are the girls doing now? I think I posted on the twins board about this (maybe? IDK lol)... all 4 of my babies have lost more than that 10% of their weight, and all 4 went in for weight checks every few days for those first few weeks. I know with our first my ped said to supplement with a bottle after every other nursing. That seemed to help a ton, since she was 6lbs 3 oz at birth, got down to 5lbs 6oz (I think, I can't remember now lol) and we just gave her the formula after every other feeding for maybe 6wks, and at 2mo she was 12lbs lol. My second, I stressed a lot less. Its silly, but we got home from the hosp and my mom wanted to feed him the bottle, and it killed me that she was feeding him, so that was the last bottle he got, and I pushed the breast hard, and he was just fine by his 2wk appt. Same thing with the twins. They got a few bottles in the hosp, after that, none, and though on the small side, they are very healthy.

Keep up the breastfeeding, I think with older kids it is much easier than preparing bottles and what not, IMO. Smile And you can pm me any time if you have a question as well. Smile

ErikaArcher's picture
Joined: 09/06/04
Posts: 379

Hope you are doing well. Would love an update. I nursed my twins til they were 2.5 and both were slow gainers at the begining - the one more so than the other. I would suggest that you work with someone hands on who is comfortable and supportive re - working with twins. You can call your local LLL leader and ask for a referral to a twin mom leader in your area. I get these calls all the time. Your other option is to hire an IBCLC and make certain your desires and goals are clearly stated. Unfortunately I have met many an LC that truely believes twin moms can't nurse without pumping, can't make enough milk, that it's "rare," or that the "trouble" isn't worth it. :confused:

It's ALL worth it. It is brutal in the early days but it will pay off ten fold down the road!

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