Interview 50

Age at interview: 35

Brief Outline: Exclusively breastfeeding twins with a toddler in the house. First child almost rejected the breast at three months. Mother's comfort (cushions essential) and positioning the baby/babies at the breast important.

Background: At the time of interview, this 35 year old, White British woman was breastfeeding her 4 month old twin sons. She also had a 2 year old son whom she had breastfed. A management consultant, she was married to an economic consultant.

More about me...

This mother of baby twins and a toddler has learned to accept and request help when she needs it. She has become a 'master of instructions' and is most grateful for the help that other people are giving her. Having help in the home can be exhausting, though, and does result in a lack of privacy. She says that she never appreciated what hard work it is to be a parent. She is very conscious that it would be easy for the older child to feel left out and jealous of the babies so she makes sure that she spends time with him alone and that his needs for regular meal and bed times are met. She also needs to pay particular attention to her own comfort. To avoid straining her back, arms and wrists she has worked out a good system of cushions and pillows to prop herself up and to position her babies simultaneously at the breast. For this reason, she finds that she is much more home-based with twins than she was with one baby She says that she eats like a horse and is much thirstier feeding two babies than one. She prefers to get an afternoon nap if she can. She also prefers to feed them both together but is aware that not all mothers of twins breastfeed that way. Her recommendation to other women expecting twins or triplets is to talk to as many people as possible who have had a multiple birth about how they do things. She also recommends reading, looking at relevant websites and contacting support groups such as the NCT and Tamba (Twins and Multiple Births Association) and keeping in touch with friends by text message and email.
 

Her baby suddenly refused to breastfeed when they were on holiday. She received help from a...

I had a fantastic birth and in the delivery suite he just took to it and fed by himself and I didn't really think back in terms of my first child at all but for the first few months he seemed to be feeding well, he was gaining weight well, we didn't really have any particular problems until he was about three months old and then we hit quite a struggle point. I'd been on holiday in a hot country and I think I had an overflow of milk, and instead of feeding a lot which is what I expected him to do in a hot country he seemed to pull away and didn't want to feed very much, and that went on for a couple of weeks, and to the point where he was really struggling with me, and it was quite upsetting trying to feed him. And I went into the local breastfeeding clinic, there's a fantastic clinic in the local hospital, twice a week.

That was once you were home?

Once I was back home from holiday yeah. And I went in there, and the lady in there said, 'Oh he looks like he's close to breast rejection' and I was quite panicked.

How did that make you feel?

Yeah quite panicky, particularly because he was refusing a bottle as well, and I'd tried expressing milk and giving him in a bottle and he wouldn't take that at all by that age, he did early on, he took some expressed milk early on, but by that age he was rejecting everything. So I was very nervous that, you know, I was going to have a real problem with feeding him at all.

How old was he by then?

He was about twelve weeks, fourteen weeks old maybe when I went to the clinic. And they were fantastic with me they said that, you know, there was a problem with the way he'd been latching on and in fact until that point he'd been almost sucking up the nipple by himself without really actively latching onto the, to the breast and he didn't have the same control of the milk flow, and they said that they thought it was really that, that he wasn't able to slow the milk down enough, and he needed to use his chin a bit more when I was feeding him, and it took a good two or three weeks of hard work to, to get it right again but from then on he was fine.

What sort of things did you do to entice him back to the breast?

I guess if he was reluctant I didn't push it I began to recognise that there were times when he'd been feeding before when it was really for comfort not for hunger, and so I let those times pass and, and really just waited till he was hungry, and I was very careful about the way I positioned myself, I probably used more cushions at that stage, 'cause you get a bit lazy with using cushions with one child I think and I used to just feed him anywhere and everywhere on my lap and, support him with my arms and, and by that stage my arms were quite tired as well so, I used to then be very careful about how I sat and used good support from the cushions. And was very careful about how I positioned his head, but even if I didn't think I was really latching him well, at least his chin was always on the breast then and, and he was, seemed much happier with it, within a week or two weeks he was fine.

Did you try feeding him in his sleep or anything like that to get him to latch on?

Not really no, he, I mean we kept the feeding patterns the same really and then he just took to it again, I think the help I had from the Breastfeeding Clinic was fantastic and, and it's run by two very, very knowledgeable ladies here, and they really tell you exactly what you're meant to try and do even if it doesn't always work. I went back two or three times and, an

She learned to attach her baby when she had colostrum but then they both had to learn again on...

How did you feel about the breastfeeding by the time you came out?

It's a funny stage those first few days because you can learn to breastfeed very well when it's just colostrum, and, the midwives and maternity care assistants were very practical and hands on in their help and they often would even put the nipple into the baby's mouth but that style of feeding doesn't necessarily work well when the milk comes in and I think the transition from colostrum to, to full milk is, is very difficult I struggled with it a bit with my first child.

What sort of things are you talking about?

I think the breasts become very full, very hard and quite painful and the babies have gone from learning to feed on a very soft, quite small breast to suddenly being faced with a rock melon and for them latching on is very difficult so the babies often kind of bounce back from the breast and the overflow of milk is unbelievable, so I did a lot of hand expressing, particularly with the twins because having two stimulating the breasts made the problem even worse, so my milk kept, came in but kept coming in for several days and I used hot towels to squeeze the milk out, poured masses of milk down the drain before I fed them for the first few days and I was quite pleased to manage that in hospital this time, I think coming home before the milk comes in is quite difficult, because you're left on your own trying to relearn how to feed the babies and I think you have to be even more careful about your technique once the milk comes in. It's a different ball game once you've got full milk, you just have to work that bit harder at, positioning them correctly and holding them still but we, we managed [laughs].

Talking to other people who had twins and getting help in the home was extremely important to her.

This time I thought about it a lot more I think, and I really, I'd had several friends who'd had problems breastfeeding even one and so again, the question about whether I'd be able to and then how on earth was I going to feed two? And I talked to those friends about how they managed it, how they held the babies, what position they fed in and different experiences of how long they'd managed to do it, and how they'd managed with two, and I obtained information from, there's an organisation called Tamba for twins and multiple births, so I obtained their booklet about feeding multiples.

And did you find that helpful?

I did find it helpful, certainly in terms of, you know the positions, the technique is still the same, the same latching on, the same, you know, holding the baby in the same way as much as you can, but just having to be slightly more innovative about your positioning and the use of cushions is absolutely essential with twins.

Did you have a support system set up by the time you came home?

Yep, yeah. Once I had the twins I had help lined up and we've had pretty much non-stop help.

What sort of help? What are the important things for somebody to think about?

For me with an older child I think it was really important to make sure that he was (a) looked after, had his meals, had his sleeps, was changed at the right times and entertained, the other thing was just to keep the house moving, to, to make sure we had food in the house, that there were meals on the table, that the washing was done, all those things are quite hard to manage when you've got a small baby and particularly when you've got three small children in the house [laughs], and to make sure that I could have some quiet time, both to rest and to feed the babies, in the early days I used to bring the babies upstairs out of the room so that I could feed them quietly on my own in the bedroom, sometimes having another pair of hands with me so that they could hold a baby once one had fed, but I quite quickly learned to be able to get them up onto my cushions and down again by myself, I figured I had to be able to do that on my own [laughs] although I know some people with twins who've really relied on other people to, to put them on the cushions and to wind them after the feed, because it's quite a manoeuvring exercise [laughs].

So you've made your priority the children?

[Mmm].

And let other people take care of everything else?

Yes, yeah.

Do you direct operations?

Totally [laughs]. I've become a master of instructions, and, sometimes it's nice, it's great to know that somebody else can, cook the dinner or do the washing for me, it's lovely, it's a real luxury, but at the same time it can be quite wearing having to constantly say, 'Would you mind doing such and such for me? Would you mind taking a baby? Would you mind reading a story' and although I have fantastic help and I wouldn't turn it down ever, I do find it quite exhausting always having somebody else in the house.

And loss of privacy?

Yeah, definitely.

Okay. What would you say to a woman who finds she's pregnant with twins, what advice would you give?

I would say try and speak to as many people with twins as you can, that might be friends, friends of friends, family, it might be going on

She mostly fed both babies at once which meant that she needed to be very organised. Lots of...

Did you latch them both on at once or one after the other?

No in the delivery suite I fed them one after the other, and I'd been told, I actually had been to the breastfeeding clinic myself when I was pregnant just to ask their advice about feeding twins and they said the key thing is to make sure you latch them on individually and can latch them well individually before you try and feed them together. So I did want to do that, but at the same time I wanted to learn to feed them together and I didn't want to avoid picking up a habit of feeding them together so, really from straightaway in hospital I tried to feed them together, somebody had lent me a quite a small u-shaped cushion, not a v-shaped cushion 'cause I don't think they work quite as well but a u-shaped one and I managed to feed them both in a hospital bed using that cushion but also about six pillows all around me propping me up, propping them up, I fed them underarm, one on each side at the same time.

The football hold?

Yeah. The football hold, some people call it 'rugby hold' I think.

Rugby football.

Yeah.

Sorry [laughs].

Don't worry, but I did have quite a lot of help from the midwives in hospital because I found it quite tricky, just, manipulating them when they're that small. And also in the early days just trying to wake them up for their feed was quite hard work, and I used to call on the midwives or the maternity care assistants to come and prod them into life before I fed them, but I think there was only one feed where I had to hand express some milk and give it to [son] in a syringe because he was a little bit reluctant, just tired, I think that first twenty-four hours often a baby is too sleepy to feed well.

A friend lent me a special feeding cushion for twins which is a blow-up cushion, and it wraps right around your body, it straps on at the back and it, it has another cushion at the back to support your back, and it's designed so that you can feed two babies, one under each arm.

And it's quite large?

It's very large and it is hot.

It has you sitting upright?

Yeah I have to be sitting on a good chair and, I usually sit either on the sofa or next to the bed so that I can leave the babies at the side of me before and after feeding, and sit in my chair and I get my cushions all in place, I strap myself in and I put a towel across to catch any drips and then I put the babies up onto the cushion and latch them on one after the other, so it's quite an exercise in logistics, you have to remember what you need and make sure it's all in place before you start feeding, get the babies lined up and then lift them each into place before you, you even start, so sometimes I have to sit down and take a big breath before I try and latch them on [laughs] and having two babies one on each side sometimes feels like a pair of piranhas pecking at you when they're desperate for a feed, they're both diving at you and it does sometimes feel like you're being attacked on all sides. But it's been fine and the cushion is, has really made a difference to my arms, my seating position, to an extent I was getting very tight in the shoulders as well and it's helped that a bit although I'd quite like to be able to lean back, unfortunately when you've got two babies with their legs out behind you leaning back isn't very easy [laughs].

Can you just talk to me a little bit about having two babies feed

Pain in her hands, wrists and pelvis was due to poor positioning. Feeding twins was a physical...

I was feeding in the bed and I used to feed them cross-legged and I started to get problems like SPD pains in my pelvis.

SPD?

Symphysis Pubis Dysfunction I think it's called, pain in the, in the middle of the pelvis which some people suffer a lot during pregnancy and I hadn't suffered at all but I think we've, the relaxin hormone that's still in your body and continues when you're breastfeeding and, with quite a lot of, probably pelvis strain from a pregnancy with twins I found when I was trying to feed them cross-legged I was getting quite a lot of pain, and my cushions often ran away with me, I had a big, long beanbag cushion which I used to wrap around myself and about six pillows propping me up in every direction and I would feed like that and it, it worked well for a month or so but then I began to get quite painful wrists and arms, and quite painful pelvis and I was really looking for any alternative that I could, I could try and get to feed them comfortably, I'd actually suffered quite a lot of wrist and hand pain when I was feeding my first child and I'd had to get quite a lot of physio on my wrists and hands to try and relieve the pain but the key problem was that I was never really supporting my wrists and arms very well, I didn't use cushions effectively enough.

We were talking about your brain and the affects that breastfeeding has on that.

Yeah, yeah. I think when you have a young baby you're very tired anyway, you're losing sleep in the daytime and there's a lot of new stresses and strains to get used to, and the thing I hadn't appreciated was that breastfeeding is another physical strain and it takes a lot out of you that you, you maybe don't realise, certainly with my first child as he got bigger, in the last month or two before he was weaned onto solid food, the amount of milk he was taking from me got bigger and bigger and I became more and more addled, I was physically tired but also, you know, slightly deranged, slightly non-focussed, not able to...

Thinking through cotton wool? [Laughs].

...Yes not able to make sense whatsoever, thinking in a complete fuzz, and I think I realised in the end that it was the breastfeeding that was making me feel like that because his sleep had actually improved by then, and it was, it was the breastfeeding that was keeping me feeling fuzzy. And I guess you just have to live through it, but it helps to recognise it, it helps to know that that's going to happen because I think I was puzzled that I felt so exhausted and I didn't really know why. 

Has it happened this time?

This time I do feel exhausted and I think that's because I'm feeding two, two at a time, and I was warned by the health visitor that feeding twins exclusively myself would be a physical drain, much more than feeding one. So this time I was more prepared for it I think and so it bothers me slightly less, plus the lack of sleep is less of a worry, when you're used to getting up at six in the morning with a toddler then, waking with the babies at six in the morning doesn't feel like anything. So usually I only have one night feed because six in the morning, it doesn't feel like a night feed any more whereas with my first child that felt like it's still the middle of the night.       

She occasionally fed her twin sons in her bed because it was easier than getting up and gave her...

You mentioned having the babies in the same bedroom and occasionally taking them into the bed'

[Mmm].

'sleeping with them there.

Yeah, yeah.

Did that ever bother you?

I do sometimes wake up in the night and think, 'Where's the baby? Is it here somewhere under the pillows? Have I buried it? Have I slept on it? Has my husband squashed it?' it does create a degree of anxiety and, and concern in me when, when I wake up but I, I'm happy to do it and I know that the babies are safe, I always sleep in a way that the baby is well supported I'm semi-wrapped around the baby so that I know where the baby's space is, I'm creating a safe zone for the baby so that even if my husband rolled over he would hit me before he hit the baby. And in general I don't think it's a difficulty, the problem for me is that if I feed one baby and move him over and then feed the second one next to him at some point I have to swap them over again [laughs] because I don't like to have them on the outside of the bed, I always have them on the inside of the bed, so I, I've sometimes had to literally swap the babies' places and I end up circling them throughout the night to keep them fed, when I can I get them back into bed, into their own bed, but, you know, I'm quite happy to fall asleep with them in my bed, if that's the easiest way. I'm up with the babies at least once and it has been, you know, several times in the night, if I can do one or two feeds lying on my side and snoozing while I feed the baby then that's great for me, it's much easier than getting out of bed, sitting on my chair, putting out my cushions, it's a bit of a palaver to feed them both together, so if I can I get away with a couple of night feeds lying down, it's more restful for me.

Are you resting during the day and are you able to do that?

Yeah if I've got help around the house with my toddler, or if he's at nursery and I've just got the twins then I often will have a sleep in the day, sometimes not because the timing of the babies doesn't work out or I can't get them both asleep at the same time but more often than not I'll persuade them to have a snooze feed if I can't get them both to sleep together, so I get one into, into bed and the other one snoozes with me and suckles while, while we snooze together, and that works, I regularly have a nap in the day, it makes a big difference.