Breastfeeding Premature Twins

Kathryn Stagg, IBCLC

July 24, 2020 | Katrina Nelson

As mothers of preemies, we learn that our breastmilk is the perfect food for our babies.

Within hours of giving birth, we are encouraged to begin pumping, so our babies will benefit from our milk. The breastmilk of preemie mothers has special nutrients, is easier to digest, and can reduce the risk of infections.

Although breastfeeding is a natural physiological process, it’s not always intuitive or easy to get our babies latched and nursing.

For mothers of premature twins, it is especially challenging. Often babies become more familiar with bottles in the NICU. While their mothers, in turn, become well acquainted with their hospital-grade double electric pump.

Kathryn Stagg, IBCLC is a U.K. based Lactation Consultant, certified through the International Board of Certified Lactation Consultants. She is also an expert in supporting breastfeeding mothers with multiples.

What makes her unique is, in addition to her professional experience as an IBCLC, she successfully breastfed, and tandem nursed her twin boys.

A while back, I interviewed Kathryn, about nursing twins, this time she’s here to offer guidance for breastfeeding premature twins.

Breastfeeding Premature Twins

Could you share your advice for a twin mom who plans to breastfeed and knows her babies are going to be born prematurely? How should she prepare, before, and after the babies are born?

If she has some warning and her health professionals think it’s safe to do so, she could do some antenatal hand expressing and collect the colostrum. This would give her a head start.

What would you recommend for a twin mom whose babies arrive unexpectedly premature, and she didn’t have time to prepare for breastfeeding ahead of time. If she only has the energy to do one thing while her babies are in the NICU, what should it be?

She should be supported to hand express her colostrum preferably within an hour after birth, but certainly within 6 hours after birth. Then to try to hand express every 2-3 hours from then on. Once her milk begins to come in she can move on to a hospital grade pump and continue to express every 2-3, not leaving it longer than 4 hours overnight.

After the Birth

What should mom do if it’s been 2 or 3 days since her babies were born, and she’s pumping every 3 hours, and she’s just getting drops?

If babies are stable enough for kangaroo care this can really help. Massaging the breast before and during the pumping session can help massively. Having photos of babies, a video, some clothes, or a blanket that smells of them can really help. And trying to relax, not watching amounts, listening to music, watching comedy, chatting to friends or family can improve. Ensuring the pump is efficient (a hospital grade pump is recommended) and that the cones fit correctly will have an impact on yield. If milk volume continues to be low then exploring whether there is a medical issue for this would be a good plan.

Advice on Breastfeeding Twins from Lactation Consultant and Twin Mom Kathryn Stagg, IBCLC

April 28, 2018 | Katrina Nelson

Kathryn Stagg, IBCLC, is a UK-based Lactation Consultant certified by the International Board of Lactation Consultant Examiners. Her philosophy, as she puts it, empowers and enables mums to fulfill and surpass their breastfeeding goals with factual, evidence based information and emotional support. With these tools, women are amazing and can overcome unimaginable difficulties.

Thirteen years ago, Kathryn received such great breastfeeding support after welcoming her twins, she decided to become an IBCLC. She now runs a website and Facebook page dedicated to helping nursing mothers of multiples.

In my own work as a postpartum doula, I’ve seen many well-prepared mothers of twins struggle with breastfeeding for various reasons. Many of the available breastfeeding books are written from the perspective of nursing a singleton, and it can take more effort to find resources focused on breastfeeding multiples.

It’s rare to encounter a Lactation Consultant who also successfully breastfed her own twins. I interviewed Kathryn so she can share her first hand knowledge and advice about breastfeeding twins.

Breastfeeding Twins

Q: I have worked with moms of twins who compare their breastfeeding experience to what they’ve read in general breastfeeding books or what they’ve witnessed with friends who have one baby. How is breastfeeding twins different from breastfeeding a singleton?

A: The actual act of breastfeeding is the same, no matter how many babies you have. The latch still has to be the same, and in order to make enough milk it is important for the babies to remove the milk frequently and effectively, just as it is with one baby. The main difference is that there are two babies! But also twin babies tend to be smaller and are often born early, not normally born after 38 weeks and often before. This impacts how easily they will be able to breastfeed, and can make the early days quite challenging, as they can be sleepy and difficult to wake for feeds.

Q: What are the time demands to exclusively breastfeed twins?

A: Basically expect to spend the first 6 to 8 weeks breastfeeding a lot. If mom prefers to breastfeed separately, breastfeeding can be pretty time consuming until the babies become more efficient later. If moms can manage to get tandem feeding going this helps massively as it can halve the time it takes! Once the babies become more efficient when they’re a few months old, breastfeeding can be really quick.

Interview with Breastfeeding Visionary Jennifer Davidson, RN, IBCLC

May 31, 2016 | Katrina Nelson

Jennifer Davidson, RN, BSN, IBCLC is a Los Angeles based Pediatric Nurse, Lactation Consultant and breastfeeding expert of nearly 30 years. She is a visionary in the field of breastfeeding, as well as the co-creator and producer of “The Milky Way” movie. She does house calls, and also works in the office of pediatrician Dr. Jay Gordon. Jennifer is passionate about helping mothers, babies and breastfeeding.

I met Jennifer five years ago during my son’s long stay in the NICU; she was instrumental in supporting me in being successful breastfeeding a premature baby. I refer Jennifer to my clients who want to breastfeed and find her expertise and positive outlook to be both comforting and confidence building.

Hi Jennifer, so, tell me… what’s in it for the mom while breastfeeding?

A mother is flooded with natural hormones during and after birth. These are her most marvelous gift. They come from within and provide for her a sense of wellbeing, strength, and calm. They impart an inner knowing, so she can begin to trust herself and her instincts.

Then why do some moms find themselves uncomfortable with a baby at the breast?

Not all women want to breastfeed, and that’s ok. But for those who do, I think society sends a lot of mixed messages regarding breastfeeding, this can create doubt and discouragement which can cause her to distrust her instincts, and often a reduction in milk supply.

What we value in our culture is not very supportive of a breastfeeding mother. In our western world, using our breasts for feeding our babies is in conflict with breasts being seen primarily as sexual objects. In movies and television the thought process often boils down to: “We need to make a lot of money so let’s show some breast.” Consumerism, sexuality, and productivity are often placed above family and babies.

The problem is that women are not respected and elevated for the most vital job in the world, mothering. When mothers have to go back to work, they are eager to provide milk for their babies, but they don’t feel supported by the overall attitude toward breastfeeding in our culture, especially in the work place, and it is very undermining. Women literally have to steal away into bathrooms or closets to pump, feeling shame and guilt for this most incredible, life-giving miracle that they alone can provide. Is it any wonder that so many women say they couldn’t provide enough milk for their babies? There is a terrible lack of cultural support. This has to change!

What are some things a mom can do to create an optimal environment for breastfeeding?

Spend as much time as possible at home with your baby, skin to skin, especially in the first 6 weeks. We have been taught that babies belong swaddled in blankets with hats on in their own basinet. We have to change this cultural image of mothering. Our babies belong on our bodies, skin to skin, wrapped in the comfort and warmth of a mother’s arms. Lay your baby on your body and get to know him or her. Become attuned with one another.

It’s a big transformation from being one person who doesn’t have anyone to be responsible for and now here you are 24 hours a day being responsible for someone else. Your body transforms from who it was to what it is now… making milk, breastfeeding, and having every single minute of your day being demanded of. You need to be able to relax so your hormones will flow, which brings a feeling of contentment. It’s not just a big chore, It’s a gift and a joy.