Estimated reading time: 5 minutes
Krista Gray, Dinas Powys, Wales, UK
Photo: Krista Gray
When I found out I was pregnant with twins, I was thrilled. I had an easy pregnancy and spent much of the time researching and planning for their birth and for life as a mom of twins with an older sibling.
We had planned to return to the US for the babies’ birth and were living in Egypt when I spontaneously went into labor at 32 weeks. By the time I got to the hospital I was already well dilated and not long after I wanted to push. The doctors were uncomfortable with my birthing premature, breech twins vaginally and they did a last-minute emergency cesarean after putting me under general anesthesia.
Those first few days were a blur. When I woke up I asked for my breast pump and began to express every three hours. The boys were given IV fluids, but no formula, that first day in the NICU. On day two they came off the supplemental oxygen. Their pediatrician was cautiously supportive of my breastfeeding but didn’t think I would carry through. He didn’t know of my resolve or passion. He told me that once my babies could suck, swallow and breathe at the same time (a skill typically developed between 32–35 weeks gestation) and were nursing efficiently, I could take them home.
Nursing my daughter had been a breeze compared to what I was now undertaking. She had been a healthy, full-term baby, whom I had birthed naturally and she had been immediately placed on my tummy to feed. In contrast, the first time I tried nursing my boys was nearly 26 hours after their birth and, though they were healthy, they were small and it took great energy for them to nurse. It was difficult with the doctors and nurses micro-managing each feed because they were concerned about the amount of milk being taken in. They weighed the babies before and after nursing, and then topped them off with my expressed milk in a syringe. By day five, the doctors were satisfied that they were eating enough for us to take them home. I was excited to be with my whole family and, looking back, glad no one told me what the next couple of months would hold!
The days, weeks and months that followed were a blur of sleepless nights, trying to breastfeed the twins and take care of their two-and-a-half- year-old sister, whose world had just changed dramatically. Being premature, they didn’t wake up on their own so I had to wake them to nurse; then top them off with my expressed milk in bottles; then pump, clean and sterilize the bottles. I did this routine every three hours, day and night. It would typically take one and a half to two hours—it took them a long time to drink milk when they were so small. With the remaining hour I would eat, sleep, play with our daughter, or try to talk with family back in the US to update them, or consult with our doctor, but I became utterly exhausted. I wanted to be diligent about pumping because I wanted to ensure I had a good milk supply. I wanted to nurse them each feeding because I didn’t want them to begin to prefer a bottle over my breast. And obviously I was the only one who could pump and nurse and it was exhausting. It got to the point where the alarm, right by my head, would not wake me, though it would wake my husband across the house, who would then have to come and wake me!
I never anticipated the pressure I would be put under from doctors to “fortify” my milk. I had loved breastfeeding my daughter and I knew breast milk was best for my boys but it is very difficult when the medical establishment pushes you to supplement or “fortify.” There were many times I felt that if they didn’t grow it would be all my fault since I had gone against this medical advice. I was thankful to be able to consult with a lactation consultant, who was a great encouragement to me. She kept reminding me that once they reached 40 weeks (when they should have been born), I’d notice the difference in their ability to nurse.
Because one of my boys continued to lose weight and/or stop gaining whenever I went exclusively to the breast (without topping him off with the bottle), I had to continue this nursing routine until around the 40-weeks mark. And then, suddenly, it really was true that they began nursing more like newborns! I began to get more sleep. I remember the night when I got seven hours of sleep—all broken up, but still, it was sleep. I felt like a new woman! They were nearly three months old, but up until then, a good night was four hours of broken sleep.
I believe the biggest challenges I faced in the beginning were more because they were preemies rather than twins. The day I packed up my pump was a day of celebration and from that time on I just enjoyed nursing my boys. I typically nursed them together, for the sake of efficiency; although if one was asleep and the other wanted to nurse I always just nursed the one. I loved being able to lie down and nurse them together and go right back to sleep—something I continued to do until they were at least a year old and just became too big. Having already breastfed a child, I knew how wonderful and easy a good nursing relationship could be and that definitely gave me a goal during the hardships I faced in the early days.
I believe the biggest challenges I faced in the beginning were more because they were preemies rather than twins.
Because they had started out so small, I was able to carry them in a sling together for many months. It was really wonderful to be able to wear them in a sling and still be able to take my daughter out and about. Many looked at the two little heads bobbing out of my chest. It was a privilege I will treasure all the days of my life.
I am glad that I never once supplemented or “fortified” my milk. Though my boys were small, they always grew according to their growth curve, and they were, and still are, rarely sick. Now, at age three, they are my amazing miracle boys and into Spiderman, swords, football and scooters.
Your milk is incredibly important for your premature baby
“Your milk is different from the milk of a mother whose baby was born full-term, and contains more of the nutrients your preterm baby needs. Formulas, even special premature formulas, increase the risk of damage to your baby’s sensitive and immature digestive system and make it more likely that she’ll get infections and illnesses, especially necrotizing enterocolitis (NEC), a very serious condition that premature babies on formula are at high risk of developing.” See The Womanly Art of Breastfeeding Eighth Revised Edition. Schaumburg, IL: La Leche League International, 2010; 345.