On becoming pregnant with twins, women are told of the dangers of the babies coming early. This is one of the fears that is put upon them from the start of their pregnancies. Now, don't get me wrong, I'm not saying it is always untrue, because babies are born early the world over, especially twins. I am, however, saying that it is a fear that is often put into the minds of parents-to-be. My response to this, as usual, is to get informed. If you are expecting twins (or indeed any set of multiples), it is a good idea to get some good information. Another good idea is to talk to your care provider about how they treat women expecting more than one baby. This is also the time to ask the 'what if' questions. Women often find themselves working from a position of ignorance when it comes to birth and breastfeeding and it is easier to sit back and let the 'experts' take over. So, I will assume that you've done the necessary research about your birth and talked to your care providers. Now, let's move on to breastfeeding premature babies.
When we talk about birth, we talk a lot about the immediate postnatal experience. Skin-to-skin contact with babies is promoted more and more by midwives and doctors, which is good news because it benefits both Mum and baby greatly. It helps the baby maintain body temperature – something that is vital in premature babies – it helps to stabilise and maintain the heart rate, respiratory rate and it generally settles the baby. It promotes bonding between mother and babies and encourages breastfeeding as the babies are more likely to root for and attach to the breast.
Kangaroo Care has been shown to have improved outcomes in premature babies. What better place to have your babies than on your skin, held close against you?
Once the babies are born, it is important to establish your milk supply, and this can be done as soon as your babies are born, no matter what stage of your pregnancy they arrive. The lovely Kellymom has some good information about establishing your milk supply and expressing. She also has a handy guide for expressing and storing milk for premature babies.
Now, why is it so important that you get your milk supply sorted for twins? After all, there are a fair number of people who will tell you that you “have to” supplement twins anyway and that “only martyrs” exclusively breastfeed. Now, let me quickly set my cards out on the table. I would LOVE for you to breastfeed your twins exclusively and my personal opinion is that the vast majority of twin mums (premature or full term) CAN exclusively breastfeed their babies. However, this is not about my personal opinion and I know that many other factors may come into play.
So, first let's see about reasons for sorting out your milk supply and remember every breastfeed counts. The milk a mother produces for her early born babies is different to the milk produced for term babies. Our milk is very clever stuff. It provides all that our babies need to protect them from infections and these can have very severe consequences in pre-term babies. NEC (necrotising enterocolitis) is one such gut infection that can be life threatening in preemies. Get shown how to hand express colostrum. This is liquid gold. Your babies need as much of it as your body produces. If, for whatever reason, you do not or are unable to produce enough milk for your babies then donor milk is an option. Ask your hospital about this or see if there is a way you can access some donor milk for your babies.
NICUs commonly have feeding schedules for premature babies. I know I sound like THE biggest fan, but Kellymom really does have great links and resources (and the lazy in me says "why re-invent the wheel"). Here are a couple of articles to read about demand feeding preemies and how it gets them home sooner. (KellyMom articles). The feeding schedules can sometimes lull parents into a false pattern. Yes, I know and recognise the importance of sleep, but did you know that your prolactin levels tend to be higher at night? This will help with expressing and your milk yield. One of the downsides of scheduling feeding is what may happen when you bring your babies home. Suddenly it feels a lot more full on and overwhelming. You no longer have those long, deep sleeps. It is one of the things that most new mums find when they bring their babies home. There are no midwives and doctors to peer around the curtain to check that all is all right. You have sole care of these babies and suddenly you have to deal with the feeding and settling at night. It may feel scary and you may begin to doubt your ability to feed them sufficiently.
The fear of hospital re-admittance, having just gotten them home, looms large. It is this fear that often leads parents of preemies to reach for formula. Coming home from a regime where everything is timed and measured may cause doubt and mums forget to listen to their instincts about their babies. They do wonderful work in the NICU and they are there to help you get your babies home, so don't be afraid to ask about breastfeeding, kangaroo care and feeding to your babies’ cues. Be informed, it will help you to manage your concerns.
Let me leave you with some reasons to be proud as you care for your premature babies and some resources for breastfeeding them.
A quick tale about expressing for premature twins.
And on one more note, should you have the privilege of meeting parents of premature babies, here are a few things NOT to say.
You can also read this and other blogs I've written on the wonderful new resource for Mums: Acorn Pack