WILL I BE ABLE TO BREASTFEED MY MULTIPLES?
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.