Breastfeeding Twins:
Problems & Solutions
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Prematurity
If your babies are premature, there is a chance they will not be able to breastfeed immediately.  This depends on how premature they are, and on their ability to latch. Some babies have to be taught to latch while others are born suckers. But not being able to breastfeed immediately shouldn’t hold you back from giving your babies mommy’s milk! PUMP! Every three hours! And feed them breast milk instead of formula while in the nursery or NICU. If the doctor or nurses say no to breast milk, ask why. And if they say no to nursing but don’t give you a good reason, ask why. Don’t simply take no for an answer! If they can’t give you a reasonable medical explanation for why your babies can’t have EBM or nurse, insist on giving it to them or doing it!
Trouble Latching
This is where Lactation Consultants come in! I had one baby who latched great right away, and the other one had some problems. Turned out she had an extremely high palate and she wasn’t getting enough of my nipple in her mouth to stimulate her sucking reflex. As soon as the lactation consultant discovered this, we devised a plan and taught her how to latch and suck properly! And she’s been a great nurser ever since! The moral of the story? Ask for help. You may not have all the answers. And you may not always know what you are doing. That’s what a Lactation Consultant is there for!
Reflux
It is perfectly normal for babies to spit up. But does it seem like your baby spits up more than he or she eats? This is a common concern for most mothers at some point. Here’s some statistics (for all babies, not just breastfed babies) to ease your mind:
• Spitting up usually occurs right after baby eats, but it may also occur 1-2 hours after a feeding.
• Half of all 0-3 month old babies spit up at least once per day.
• Spitting up usually peaks at 2-4 months.
• Many babies outgrow spitting up by 7-8 months.
• Most babies have stopped spitting up by 12 months.
Still concerned? There could be a few causes for breastfed babies, including: oversupply of breast milk or very heavy let-down, acid reflux (for which you can get meds and which breastfeeding actually helps), and sensitivities to foods that mom ate. If you think it is a problem, don’t hesitate to bring baby to the pediatrician to discuss your concerns!
Thrush
Thrush is simply yeast that has grown in baby’s mouth, on your nipples, or both. You will be able to see white patches on the inside of baby’s mouth if he or she has thrush. Symptoms for mom include: itchy or burning nipples that appear pink or red, shiny, flaky, and/or have a rash with tiny blisters; cracked nipples; shooting pains in the breast during or after feedings; intense nipple or breast pain that is not improved with better latch-on and positioning; and deep breast pain.
Thrush can cause sucking to be painful for baby, and can also cause nursing to be painful for mom, so it is best if you all get treated for it at the first sign. Often both babies will need to be treated, especially if they share pacifiers, spoons, breasts, bottle nipples, etc. Doctors can proscribe medicine for baby to treat thrush, and mom can use Lotrimin AF cream (for Athlete’s Foot) on her nipples after each feeding to kill any remaining yeast. You can also get a prescription for Diflucan from your own doctor if needed.
You and baby can also take probiotics to prevent thrush. These do the opposite of antibiotics, and actually supply your body with the bacteria to prevent yeast from multiplying. You can ask your pharmacist where to find the probiotics. Although they are available over the counter, many pharmacists keep them refrigerated. Other home remedies to treat/prevent thrush include: washing everything that comes in contact with your breasts in HOT water with bleach and drying in the dryer or in the sun, rinsing your nipples with a solution of 1Tbsp vinegar and 1 cup water after every feeding, and reducing yeast and sugar in your diet. It is also recommended that you boil all nipples/pacifiers/spoons/toys/etc. that come into contact with baby’s mouth on a daily basis.
Engorgement
Engorgement can be uncomfortable and sometimes even painful, not to mention embarrassing when you’re in public or have company! It is most common when your milk “comes in” between 3-5 days after birth, and lasts anywhere from 12-48 hours with proper treatment (7-10 days without). Your breasts become warm, tender, and literally hard as rocks. And it can affect the baby’s latch because the nipple and areola are often stretched out to become hard and flat as well. Tips for treating engorgement include:
Before nursing: -gentle breast massage toward nipple prior to nursing
-cool compresses for up to 20 minutes before nursing
-moist warmth for a few minutes prior to nursing (can increase swelling
and inflammation if used for longer than a few minutes
-hand expression, pumping for a few minutes, or reverse pressure
softening prior to nursing to aid baby in latching
During Nursing: -massaging breasts while nursing
-re-latch baby after a few minutes (when breasts have softened) to aid
baby in latching properly
Between Feedings : -hand express or pump to comfort, but do not pump too much, as the more
milk you demand by pumping/feeding, the more you will make
-use cold compresses for 20 mins on, 20 mins off
-use cabbage leaves
-wear a well-fitting, supportive bra
-use a non-steroidal anti-inflammatory like ibuprofen with permission
from your doctor
Clogged Ducts/Mastitis
Another painful problem, clogged ducts and mastitis are simply obstructions that stop the smooth flow of milk out of the breast. A clogged duct is simply a duct that has been clogged and is overfull, therefore causing pain; and mastitis is an inflammation of the breast resulting from a clogged duct. These two problems result from blocked milk flow (either from engorgement, inadequate milk removal, infrequent feedings, pressure on the duct, inflammation), or from stress, fatigue, weakened immunity, and anemia. The best treatment for both clogged ducts and mastitis is to CONTINUE NURSING. Keeping the milk flowing will help to relieve pressure, as well as encourage the blockage to dissolve or be passed. Also, ensure you have an adequate fluid intake, are eating nutritiously, and are resting. Heat and massage also work wonders. Massaging the breast while in a hot shower or while nursing is a great help. And ensure that you are draining the breast as much as possible during each nursing by having baby nurse on that side first each time, but be sure not to neglect the other breast.
Milk Blisters
A milk blister is caused by skin growing over a milk duct opening causing milk to back up behind the skin, causing a blister. This is painful, and often is a small white, clear, or yellow dot on the nipple or areola. Moist heat prior to nursing is recommended, as is a saline soak before the moist heat several times a day. You can also remove the skin blocking the duct yourself using friction, a fingernail, or simply pulling on it if it protrudes from the nipple. It is not recommended to use a sterile needle to pop these blisters yourself. If this treatment is needed, it is suggested you contact your doctor.
Nipple Pain
Sore nipples are most commonly caused by poor positioning, poor latching, or poor suckling. The best treatment for this problem is prevention, by ensuring that baby is positioned well, latching properly, and suckling well from the start! Preventing nipple pain would be a great reason to ask for a lactation consultant right away in order to ensure baby is positioned, latching, and suckling right!
Flat/Inverted Nipples
Because a good latch requires that baby takes most (if not all) of your areola in his or her mouth, flat or inverted nipples are often not a problem. Once baby latches and begins to suck, the nipple will often be pulled out by the pressure. If it does seem to be an issue for you or baby, there are many different ways to solve the problem, including the use of breast shells, using a breast pump or Evert-It Nipple Enhancer to draw the nipple out, nipple stimulation, pulling back on the breast during latch, or nipple shields. A lactation consultant will also be a great help in overcoming this problem!
Nursing After a C-Section
Nurse as soon as possible after your surgery! Unless you are on a medication after surgery that the baby should not have at all (like morphine), there is no reason why you can not nurse as soon as possible. And if this is not possible, pump! Whether you have to pump and dump because you’re taking medications unsafe for baby, or you are pumping and feeding baby, you must continue either feeding or pumping to ensure that your milk comes in on time and your milk supply is ample. This would be another great time to ask for the assistance of a lactation consultant! To avoid pain at the incision site, place a pillow over your abdomen prior to nursing, or use the football hold until your abdomen is a bit less tender. |
