07 November 2009

Breastfeeding Twins Part 4: Reflux and Growth Spurts

The middle two weeks of October passed with very little difference in routine. I fed the girls from the breast 2-4 feedings a day and pumped the remainder.

Setting up to nurse tandem by myself is quite the adventure. First, I heat the breast shields. Next, I set up my pillow and nursing stool on the couch that I want to use for that feeding. Then, I go change the first baby and bring her back to the couch. I lay her on the couch and repeat with the second baby. Then I strap on the pillow and pick up the baby who is to eat off of my right side. I put her on the pillow as I sit down and scoop up the left side baby. Then, I apply the nipple shields while both babies scream in hunger while flailing around doing there best to dislodge the shields from my nipples. Then you latch one at a time while hoping the one who is screaming doesn't roll herself off. Whew! By the time that process is over and the girls are happily sucking away, don't be surprised to find me asleep while they eat!

The last week in October was not a happy one. Derek's sister had come up to visit and the girls were extremely fussy after each feeding. They were also spitting up quite a bunch. It seemed normal to me until I went to the Upstate Mother of Multiples Club Meeting Tuesday the 26th. Amber was feeding Aeralind and I was feeding Bronwyn expressed milk and the two of them practically spewed their entire bottles on both of us. Both burp cloths were soaked and every lady who held them was sporting spit up of some kind. They all encouraged me to call my pediatrician; that was not a normal amount of spit up!

So I called and told the pediatrician that their crib looked like a biochemical war zone with the amount of spit up. The nurse told me they probably had a milk protein allergy. I cried! Those 500 or so extra calories I'm eating a day are probably all composed of dairy. What was I going to eat?! I couldn't imagine breastfeeding and not getting to eat anything with milk in it.

Just in case it was something wrong with the digestive tracts of the girls the nurse told me to come in that afternoon. I was exhausted from their spit up the evening before, but I managed the trip alone. Dr. Woodleif took extra special care of me since this was the first time I had gone to her office alone and she could see how stretched I was. I told her that the girls ate heartily and then would start screaming. They would scream and then spit up. Pause a little while and then scream and spit up again. They knew what was coming. She asked me if the girls arched their backs before the spit and I replied that they did; it was like ready, aim, rush to get the burp cloth!

Dr. Woodleif diagnosed us with reflux and not a milk protein allergy! I'm giving my 8 week old twins Zantac three times a day which seems totally crazy to me. However, as they developed the reflux they had gone from sleeping six hours a night to sleeping 3 hours and then being up 30-90 minutes screaming and spitting. I needed sleep again! It's been about a week on the Zantac at this point and the difference is striking. We no longer need two burp cloths per baby at their night feedings. I am so glad that the problem was not one I was creating for the girls.

One of the other nightmares of breastfeeding twins are growth spurts. With one baby I'm sure that a growth spurt is incredibly exhausting since the baby wants to feed all the time. I think the physical exhaustion level is probably about the same for mom's of multiples, but there is an added level of anxious exhaustion. Twins, even my apparently identical ones, do not go through growth spurts at the same time. Perhaps this doubles the physical exhaustion, but worst of all it disrupts The Feeding Schedule.

As a twin mom who wants a few moments during the day in which to pursue non-twin related activities, The Feeding Schedule is extremely important. Now I'm not so strict as to make my babies scream it out because it hasn't been three or four hours yet. I pretty much feed on demand and hope they start stretching themselves to the four hours. But if one baby wakes hungry, then I wake the other baby to eat as well; if I didn't do this, I would be engaged in baby care 2 1/2 hours out of every three! Normally waking one because the other is hungry isn't an issue. The sleeping twin will greedily eat on the the hungry twin's cue. But during a growth spurt, one of the girls will want to feed almost twice as often as the other.

The Feeding Schedule for about six hours normally looks like this:
  • Hour 1: Change and feed the girls.
  • Hour 2: The girls play for maybe 30 minutes while I do housework nearby. Then, they start crying to be put to sleep.
  • Hour 3: Girls sleep and I get to do what I want!
  • Hour 4: Change and feed the girls.
  • Hour 5: The girls play for maybe 30 minutes while I do housework nearby. Then, they start crying to be put to sleep.
  • Hour 6: Girls sleep and I get to do what I want!

The Growth Spurt Feeding Schedule looks like this.
  • Hour 1: Change and feed the girls.
  • Hour 2: The girls play for maybe 30 minutes and I do housework nearby. They both sleep for about half an hour.
  • Hour 3: Baby A wakes up screaming for food. I wake Baby B and attempt to feed them both. Baby B falls asleep at the breast.
  • Hour 4: Starts with both girls asleep, but quickly Baby B will realize she is very hungry and will demand to eat.
  • Hour 5: Baby B is awake playing, but is then put in bed to sleep. I panic about having enough time to make dinner and scourge up some canned soup.
  • Hour 6: Baby A is begging to eat again, I am crying and freaking out about the potential of being woken up every hour in the middle of the night. I attempt to let her scream it out until B wakes up but I can't bear it for very long and attempt to make Baby B eat again.
  • Baby A eats greedily and drifts off to sleep at the end of the feeding. Baby B refuses to eat or falls asleep at the nipple.
As you can see, my anxiety level increases drastically during a growth spurt. Add to that fears that the reason Baby A keeps waking is because you're not making enough milk and you can imagine just how many tears are flowing some days when my husband walks through the door. He tells me immediately to go to bed and somehow, almost magically, when he wakes me for the next feeding he has them eating at the same time. They are mesmerized by him. What woman wouldn't be mesmerized by such an amazing man?

This post sounds kind of drastically negative, but honestly most days now breastfeeding/pumping is more of a well oiled routine. I'm still using nipple shields and they are still growing. And best of all, I'm not having to buy expensive formula for two babies! Those savings mean that I can shop for more clothing that fits my new twin figure ;)


aprettythought said...

I haven't been able to get online for a while but i wanted to tell you how amazing this series of post are. i love how real they are. i think it's a good resource for other mothers with twins. even though i'm not pregnant and won't be for some time, i think it opens even my eyes to what i will have to expect. i don't know. this post might be silly but i just wanted you to know that i love it and that i'm so very proud of you.

Fran said...

Currently in the midst of a twin growth spurt....thanks for your post, good to know this is "normal" if there is such a thing anymore!

Melissa Ann said...

Glad I could make you feel normal, Fran :) Don't hesitate to shoot me an email if you need another taste of the new twin normalcy :)

Anonymous said...

My problem is not my twins... They are 12 weeks old now... The moment they wake up, my MIL tells me to feed them. After a bath, they would be playing, but she says that I HAVE TO feed them as bathing makes them hungry...i would have loved to let them play as much as they wants... But no.. She would fprce me to feed and they fall asleep..When one of them pees, she finds out and she says "see... All the milk you gave has now gone with the pee... Now feed him again... If they pee, they'll be hungry..." so what i do all day is feed, feed and feed.