Ruth Cumming has breast hypoplasia or insufficient glandular tissue (IGT) and as a result struggles to produce a full milk supply. She mix fed her first two singleton babies, gradually reduced the formula once they were weaning onto solids, and continued to breastfeed them until they self weaned at 4 and 2 and a half respectfully. Then she found out she was expecting twins! Here Ruth talks about her journey. Her original blog can be found here and she has blogged about breastfeeding her singletons too. She has trained as a Peer Supporter with the Association of Breastfeeding Mothers so she can support others.
The last time I wrote about breastfeeding the twins, they were 3 weeks old and things had gotten off to a great start. I’m pleased to say that it has continued to go very well for us. We’re now coming up to six months on Wednesday, which is quite a bittersweet milestone. On the one hand I’m glad that as they start to eat solid food, the amount of formula that we’ll need to supplement my low milk supply will decrease, and that other people will be able to help out with their nutrition intake. But on the other hand I enjoy being the centre of their world, and although I’ll still be that for a long time, this marks another step in their journey to independence. Don’t get me wrong, I do have days when it’s exhausting and I don’t enjoy it so much, but overall I’m happy to respond to their nutritional and emotional needs in this way and will miss it as they need breastfeeding less over time. I plan to let them self wean like the older boys did, so I don’t know how long we’ve got, but I hope quite a while yet.
There have been ups and downs over the past few months, particularly with regards to sleep. The dreaded 4/5 month sleep regression hit at around 4 and a half months. This is a completely normal developmental phase and shows that they are learning lots of new skills, but it was extremely difficult with twins! When all is well I don’t think twins are any harder than two singletons close in age like I had with the boys, but when they’re going through a leap/growth spurt/sleep regression at exactly the same time, that’s definitely the hardest part about twins compared to two singletons. I have done lots of overnight feeding, though sometimes they’d be awake without wanting milk. Before the regression I used to prefer tandem feeding them as nice sleepy babies at night, so I’d try to wake Naomi to have a go at feeding when Samuel inevitably awoke before her, and she’d sometimes have a bit of a dream feed but was pretty much sleeping through the night (much to my amazement at this age as none of the boys have done that so young!) But once the regression hit I preferred to feed them lying down in bed to maximise my dozing time with all the wake ups, and that’s only really possible for me one at a time, so I would actually be quite thankful if they tag teamed then, as long as they settled again, which wasn’t always the case and my days ended up starting at 3/3:30 am! A few things really helped us get through the increased night waking. Firstly we have a bed which is set up for safe co-sleeping. Next to our double bed is a cot bed with one side off that is attached with cord to the bed frame, and the mattress pushed right against our bed with noodle floats (under the sheet) down the gap against the other side of the cot bed. This means the babies have their own space, but I can simply slide them to and away from me to feed in the night as needed. Tom sleeps downstairs so I have the double bed which allows me to tandem feed safely sat up with the tandem pillow if necessary. I would find it much harder to settle them both, and get up and bend down over in to a separate cot if we had that.
Secondly I have taken any opportunity to nap in the daytime when I can. This means weekends when Tom is around and some weekdays when my parents have come over. I go to bed when the babies settle anyway, so I can’t get any earlier a night, but even just an hour in the day makes me feel better. The babies nap well in the slings for Daddy and grandparents too whilst I nap. Some might say that it would be helpful if others could give them a bottle and give me rest in that way, but unless someone is going to help me all through the night, it wouldn’t really gain us anything. I’d rather Tom got sleep so he can work well, look after the boys and do housework, which I’d only have to do instead if he helped feed the babies. And I’d rather sit and feed babies whilst tired than try to do anything else.
Thirdly I find with breastfeeding that I get back off to sleep much more quickly after being woken than I have done in the past when not breastfeeding. This is down to the hormones involved. So if I’m going to be woken up, I like the fact I drop off again as soon as they settle. I think that aspect would be much harder for me if I wasn’t breastfeeding because I know I find it hard to fall asleep again if woken abruptly. Thankfully we seem to have come out of this sleep regression now, after about a month of broken sleep, ranging from mildly unpleasant to downright horrendous nights within that month. Naomi is back to sleeping ridiculously well for her age and Samuel is normal for his age with a few wake ups for feeding and relatively quick to settle. I seem to have written a lot about sleep here! It is inherently linked to feeding because most of the times that they wake they want to feed to some extent, though there have been times when they were just wide awake and happy in the early hours without wanting milk. And the fact that they have spontaneously snapped back into each of their “normalities”, without us changing anything, shows it wasn’t that they needing weaning into solids to help them sleep any better, which is still quite a prevalent idea in our society despite the NHS advice to wait until around 6 months to introduce solids. Before they were born, one of my apprehensions about breastfeeding twins was the logistics of feeding both together or one after the other, and also how that would work with our set up with the supplemental nursing system (SNS). I have been so pleased with my second hand purchase of the Peanut and Piglet tandem feeding pillow. It fits my body shape and size brilliantly and is so comfortable for the three of us. The twins still fall asleep on it sometimes and I usually enjoy the rest I get when trapped underneath it, which is even more comfortable with the addition of a travel neck pillow to rest my head. I can see us using it for several months to come; I think they’ll grow out of it in terms of their arm flailing and whacking each other at the front before they grow out of it length wise! I don’t tandem feed all the time, less so when I have help to entertain the other one, and often even if both are on the pillow with me they’re not necessarily both feeding simultaneously, sometimes I’m just holding the non-feeding one sat up next to me.
I’m also really pleased with how our homemade supplemental nursing systems have worked this time. I got into using the homemade version towards the end of feeding Joel with it, having previously relied on the branded version with both boys. Our version is basically an ordinary baby bottle with a thin (size French 4) NG tube pushed through the teat. I find this system easier to clean and sterilise than the branded one, and the flow seems easier to regulate. I found some tubes on eBay – they are puppy feeding tubes – and then got some more through a family member who is a vet nurse. Since we have bottles anyway because I mix up formula in those as it’s not really possible to do it in the branded SNS itself, this makes the homemade version quite a bit cheaper. I use a Lactaid branded system when out and about because it has a neck strap so I can keep it there under my top to feed as and when I need to when we’re out. I was kindly gifted this by another twin mum, but I wouldn’t buy one myself as it is very expensive to import from the USA, and to use long term would work out even more expensive as you have to buy more disposable bags to refill. I don’t need a neck strap at home because I can rest the bottle on the tandem pillow or hold it in my hand when single feeding. I’ve found that it’s only practical to feed one at a time with the SNS, because even with the tandem pillow I need both hands to position the tube properly on each baby at a time, and since they’ve been more grabby with their hands and pull it out a fair amount when feeding, it’s impossible to have two tubes – I’ve tried a couple of times and it just ends up a big flailing mess. But it seems to work out that one is happy to suck on bare breast while the other has the tube, and only when they are both really grumpy or overtired does tandem feeding get a bit vocal. I’ve not been able to connect with any other twin mums who have used the SNS long term, so it’s been a case of experimenting with what works for us. Both babies seem to be feeding, growing and developing well, so we’ve not changed things when they’ve worked. It’s such a good feeling to be able to say that the twins have been fed exclusively at the breast for 6 months! They haven’t had a single bottle in that time, and I don’t intend that they will ever need one now. Of course they have had formula to top up my supply, but it’s all been consumed via the SNS. This means they have maximised the amount of milk they’ve got from me, and we’ve been able to enjoy the benefits of a breastfeeding relationship that go beyond the milk. I know that for twins we are blessed to be in this situation. It’s not unusual for twins to be born early and therefore struggle to feed at the breast for days, weeks or months. Despite my chronic low supply, we’ve had it quite easy in this respect. Strangely I don’t feel that unusual in the twin breastfeeding world compared to in the singleton breastfeeding world. I think it’s because lots of twins end up being mixed fed breastmilk and formula at some point, either short or long term, and for the first time I’ve really felt like I fit into the online breastfeeding community in the form of the Breastfeeding Twins and Triplets UK Facebook group. It took me to have twins to feel like I belong!
It’s apt that in the same week that were marking 6 months, I’m also starting an online course with the Association of Breastfeeding Mothers to become a breastfeeding peer supporter. I’d been thinking about this for some time, but when the opportunity came up to do it with a funded place via a crowd-funder campaign in the Facebook group I mentioned above, I thought it was finally the right time. I think my experience would be useful to share with other mums, in terms of twins and breastfeeding with low supply. I’ll blog more about how I intend to use the qualification when I’ve done more of the course. I know there will be more challenges ahead, but 6 months feels to me like the hardest milestone to reach, so it’s a big achievement in my mind to celebrate, and the first one I was determined to get to. I’m looking forward to the next 6 months and beyond now.
Ruth Cumming, Dec 2017