WILL I BE ABLE TO BREAST­FEED MY MUL­TI­PLES?

Your Baby & Toddler - - BREASTFEEDING -

Breast­feed­ing twins or triplets is def­i­nitely pos­si­ble. Plan ahead and get plenty of sup­port so that you’re able to fo­cus on your ba­bies. If you can af­ford it, get help with your house­work, a nanny, or a night nurse to as­sist you through the chal­leng­ing early weeks or months. You could also ask your hus­band or rel­a­tives to step in.

De­pend­ing on the ges­ta­tional age of the ba­bies and the cir­cum­stances that sur­round the birth, the sit­u­a­tion can have many dif­fer­ent sce­nar­ios that will de­ter­mine your goals with re­gards to lactation. Should the ba­bies be born early, it is of ut­most im­por­tance to ini­ti­ate and pro­tect your milk sup­ply. Reg­u­lar breast care and cor­rectly ex­press­ing with an ef­fi­cient breast pump will help with this. Many hospi­tals do have dou­ble elec­tric breast pumps avail­able for NICU moms.

It may hap­pen that one baby is well and able to stay with you, but the other needs spe­cialised care in the NICU. In this case, you will need to ex­press milk for the other twin while nurs­ing the health­ier twin at your breast.

If nei­ther of your ba­bies needs a stint in the NICU, the ideal is to do skin-to-skin con­tact and be guided by each baby’s feed­ing de­mands. It may be eas­ier to feed one at a time to en­sure that each baby is ef­fec­tively latch­ing and feed­ing well. Once you get to know each baby and their in­di­vid­ual cues, then you could save time by feed­ing them to­gether. Po­si­tion is im­por­tant to make sure that each baby – and you – is com­fort­able. The most com­mon hold for twins is the rugby hold, with each baby held un­der an arm with their legs fac­ing to­wards your back.

Feed­ing triplets re­quires a dif­fer­ent strat­egy. If all three ba­bies are breast­feed­ing, then of­fer Baby One and Two a breast each. Then feed Baby Three on both breasts after that. Ro­tate the ba­bies at each feed time (Baby Two and Three on a breast each, with Baby One on both breasts, and so on).

If the ba­bies are born pre­ma­turely and are un­able to latch, then ex­press­ing your milk is the next best op­tion.

Re­mem­ber that each mom of mul­ti­ples’ sit­u­a­tion is unique and in­di­vid­ual, so call in a lactation con­sul­tant if you’re strug­gling.

The South African Mul­ti­ple Birth As­so­ci­a­tion (SAMBA) is a use­ful source of sup­port, en­cour­age­ment and mo­ti­va­tion.

Mak­ing con­tact with a lactation con­sul­tant be­fore the birth of your ba­bies will help to give you the cor­rect guid­ance.

LACTATION CON­SUL­TANTS

Most lactation con­sul­tants in South Africa are in pri­vate prac­tice and con­sul­ta­tion fees vary. De­pend­ing on your med­i­cal aid plan and how you are in­voiced, you may have the op­tion to claim the con­sul­ta­tion fee back through your med­i­cal aid. You can find a con­sul­tant near you by brows­ing on web­sites below.

La Leche League has sup­port groups in var­i­ous ar­eas around the coun­try. breast­feedin­gonline.com ilca.org In­ter­na­tional Lactation Con­sul­tant As­so­ci­a­tion (ILCA) pro­vides re­fer­rals to in­ter­na­tional board-cer­ti­fied lactation con­sul­tants. salac­ta­tion­con­sul­tants.co.za milk­mat­ters.org breast­feed­ing.org.za You can also use the links pro­vided through this web­site.

Breast­milk di­gests eas­ily and matches a baby’s sleep cy­cles. As long as your baby is feed­ing ef­fec­tively, and thriv­ing, then there is no rea­son for con­cern. Iden­ti­fy­ing the rea­son that your baby is feed­ing fre­quently will help you to ac­cept the feed­ing pat­tern that your baby has formed.

In the first few days, your new­born needs to stim­u­late your breasts to es­tab­lish a sup­ply that is suf­fi­cient. As your baby grows, he may go through pe­ri­ods where he stim­u­lates your breasts more of­ten to in­crease your sup­ply ac­cord­ing to his grow­ing needs, which will settle within a few days. This is not an in­di­ca­tor of how much milk you have. Giv­ing any ex­tra flu­ids or foods to your baby, in­ter­feres with breast­feed­ing and may be the start of many prob­lems ahead.

In the af­ter­noon, your vol­ume of milk may be lower than at any other time of the day. As a re­sult, your baby may want to clus­ter feed for a few hours to get enough to help him settle longer in the night hours ahead.

Some­times your baby may want to suck for com­fort and to re­lieve symp­toms such as thrush or re­gur­gi­ta­tion.

Rest as­sured that your breast­milk is the per­fect food for your baby, and is all he needs for his first months of life. Giv­ing him any ex­tra flu­ids or foods in­ter­feres with breast­feed­ing and may be the start of many prob­lems ahead.

CAN I CON­TINUE TO BREAST­FEED WHEN I’M SICK?

If you have a mi­nor in­fec­tion such as a cold or flu you should con­tinue to feed your baby as usual, or even more of­ten. The an­ti­bod­ies that you are build­ing to fight off the in­fec­tion are passed through your breast­milk to pro­tect your baby. Even through mild gas­troin­testi­nal up­sets, it is rec­om­mended that you breast­feed. Make sure you keep up your flu­ids when you’re sick and drink small sips of re­hy­dra­tion so­lu­tion to re­place flu­ids you may have lost through vom­it­ing or di­ar­rhoea.

Breast­feed­ing is all about gain­ing con­fi­dence to know you can do it! The golden rule of breast­feed­ing is to know the law of de­mand and sup­ply. The more your baby ef­fec­tively feeds, the more milk is made. This is the key to es­tab­lish­ing and main­tain­ing a suf­fi­cient quan­tity of milk to ad­e­quately nour­ish your baby. In the first few weeks after birth:

Your baby will gain an av­er­age of 170 grams per week. Most ba­bies lose five to seven per­cent of their birth weight after birth, and usu­ally re­gain their birth weight within two weeks of age.

Your baby will have more than three bowel move­ments per day, and at least six wet nap­pies.

You will no­tice swal­low­ing and ac­tive feed­ing when your baby is at the breast.

You will note your breasts are fuller be­fore a feed and softer after feed­ing.

Your baby is con­tent and sat­is­fied and set­tles eas­ily after feeds. If your baby is latched on and suck­ing cor­rectly, then there is no need to limit the length of his feed­ings.

Watch your baby closely dur­ing feed­ing. Note his in­ter­est and re­sponse – he needs to be ac­tively feed­ing and suck­ling ef­fec­tively to be do­ing well.

If he tires, en­cour­age him to con­tinue, by call­ing his name and talk­ing to him. Squeeze your breast a bit to en­cour­age him to re­lease your nip­ple and come off with­out dis­com­fort.

Give your baby a lit­tle break to wind. Burp­ing your baby doesn’t only al­low him to bring up trapped air, but also wakes him from his “milk coma” so that he will be more alert when you of­fer the other breast to fin­ish the feed. you are breast­feed­ing, un­less you per­son­ally note any re­ac­tions that you think may re­late to what you are eat­ing.

It re­quires a lot of en­ergy for your body to man­u­fac­ture the milk in your breasts. An av­er­age of 2000 kilo­joules (610 calo­ries) are re­quired each day to do this, and should be ob­tained from healthy, nu­tri­tion­ally dense foods.

Pro­tein and un­re­fined car­bo­hy­drates should be a good part of your daily in­take, in­clud­ing veg­eta­bles and fruit. A va­ri­ety of foods is the key. Make a list of quick, high en­ergy snacks and keep them in stock. Fresh fruit, av­o­cado pear, crack­ers and cheese, cream cheese, baked potato (which you can pop into the oven while feed­ing), sand­wiches/toast with nut but­ters, eggs, yo­ghurt and ce­re­als, nuts, seeds and dried fruit are good foods to in­clude in your daily diet. they no­tice a slight dip in their sup­ply and that their baby is some­what fussy after they start to take the minip­ill. This is also noted when moth­ers start men­stru­at­ing. With cor­rect guid­ance and mo­ti­va­tion, moth­ers can get through this short pe­riod of change. Pump­ing for a short time di­rectly after feed­ing and al­low­ing baby to feed on de­mand usu­ally cor­rects the sit­u­a­tion. Rest and flu­ids also con­trib­ute to quickly get­ting back to nor­mal.

Read more about your con­tra­cep­tive op­tions in our fea­ture on page 82.

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