Thursday, June 21, 2012

My baby feeding dilemma


There are always concerns in a pregnancy, particularly surrounding how the labour and birth will go.  It’s only natural, as it’s impossible to know how everything will play out, even if you’ve been through it before.  I think if I was pregnant with a singleton, I’d have less worries surrounding the birthing.  Probably my main concern would be getting to the hospital quickly enough, since my labour with Andrew was considered short (about 8 hours total).  With twins, I have some anxiety over getting to the hospital in time, since we live a lot farther away from the hospital we’re birthing at this time around.  But my main concern at this point has to do with my milk coming in when it needs to.

With Andrew it was ‘easy’ because he was late, and therefore my body was more than ready to start producing milk for him.  I had a very natural birth, so everything felt like it fell into place as it was meant to.  Andrew was considered a ‘big baby’ at 8lbs 9oz.  Very healthy, very strong.  There was no need to supplement with formula, because he began suckling right away, and I had enough colostrum to tide him over till full on milk production began.  Even 2 months after Andrew STOPPED nursing at 18 ½ months, I could have started breastfeeding again.  As far as I know, my milk production was about as good as it gets.

Now the issue is that with subsequent births, you never know how your body is going to react.  I could have had the most successful breast feeding experience the first time around, but the next time it could be completely different.  With twins, it’s further complicated by the fact that I’m going to need double the amount of milk for double the amount of baby!  It’s complicated by the fact that on average, twins are 5.5lbs each at birth.  From the women I’ve talked to who have had twins, one baby is generally smaller than the other at birth.  Sometimes by quite a bit, where one twin needs a lot of extra nourishment in the beginning to try to get their weight up.  It’s not always this way – it is possible, if birthing doesn’t happen till more like the 38 week mark, that both babies can be a stronger, healthier weight from the get go, and exclusively breast feeding IS possible.

But often it seems to be the case that supplementing in the beginning is a necessity, because one or both babies isn’t getting enough from breast milk.  Sometimes they are so small they have suckling issues, and it’s hard to get them latching properly in the beginning.  Sometimes Momma’s milk doesn’t come in as early as needed, for various reasons, such as due to having had premature babies, a c-section, being induced – I even question whether having an epidural can cause breast feeding complications (and my doctor seems to want to 'automatically' do an epidural, regardless of how the labour is going...I still need to discuss this with her more).  Since 50% of twin births happen via c-section, I worry about my odds of having a more natural labour, and my milk production being similar to what it was when Andrew was born.

I don’t have a problem with formula fed babies.  I wouldn’t mind supplementing with the stuff if I didn’t feel like it was so complicated in our situation.  The thing is, from the research I’ve started doing, it’s not easy to find vegetarian formula.  Most formula seems to have fish-based omega 3’s added.  As well, I’ve even discovered that some formula has pork in it, as some enzyme from pigs is used.  I have to be perfectly honest, the idea of it freaks me right out.  I love the fact that Andrew has been vegetarian since he was conceived.  Yes, he might choose to make other food decisions in his life than what I would want for him, but at this point in time it’s up to me to provide his diet, and I love that I’ve been able to raise a perfectly healthy child on a completely vegetarian diet. 

There’s no reason why it should have to be any different with the twins.  And I know there ARE vegetarian formulas out there, I just have to do more research to find them.  I’m not entirely sure how I feel about soy-based formulas, as I’ve read that soy isn’t the best thing to give small babies in large quantities.  I need to do more research on that.  But ultimately it’s not that my babies need to be vegan!  In fact, they won’t be, because I eat dairy, and it’s therefore in my milk.  And I’m really hopeful that my milk WILL come in, and I WILL be able to exclusively breast feed.  But I need to figure out what I’m going to do if for some reason I have to supplement, and it’s scaring me a bit.

You can also go the route of ‘donor milk’, where you purchase breast milk from mom’s who have donated some of their supply to a milk bank.  You can get it through BC Women’s, which is where we’ll be delivering.  But I’ve decided I’m not a fan of the idea of using some other woman’s milk to feed my babies.  I would honestly rather go the route of formula than to give my babies some other woman’s milk.  It’s hard to put into words exactly why I feel that way, although I suppose there are multiple reasons.  For one thing, there’s no way of knowing if the woman who donated the milk I get was vegetarian, so I’m still going to have the issue of feeding my babies milk that contains animal, which I’m really not for.  I also feel that while they DO test the milk for safety purposes, I worry that they could possibly not detect something that could be wrong with it, and it just seems kind of gross to me.  Maybe it’s also a territorial thing, but I don’t take well to the idea that some other woman is nourishing MY babies, and not me.  If I can’t do it on my own, I’ll have to find a formula that can help complete the job.  I just need to find out what would be healthiest for my babies,  and I stand by the fact that we can do it vegetarian.  Of course if it came right down to it, if it’s a life or death situation that I use an animal-based formula, I would do it.  But I’m 100% certain that it’s NOT actually necessary.  I know that in general, the reason animal products are used when other things COULD be with the same effect, it’s because it’s cheaper for production to do it that way.  It’s not because it’s the only way to healthily feed one’s child, which I know from experience.  I guess I just have some more research ahead of me to get this stuff figured out.

I wish it didn’t have to be so complicated!  I wish I could just know that my babies will be born healthy and my milk will come in and all will be well in our world.  But not knowing means I have to be prepared for whatever might happen.  At least I’ve got some time to get this stuff sorted out before it really matters!

6 comments:

trista said...

I am heading to bed but as you know I am extremely passionate about birth and breastfeeding education etc. I just want to give you a heads up that I have LOTS to say on this... and to expect a pcomment or email sooon! (if not then I may need a little reminder ;)

Elizabeth said...

Sounds good, I am definitely interested to hear your insights on this topic! I should also start doing more research on the possibility of having a doula, for some reason I've been putting it off but I'll let you know if I have any questions about that as I go along! XO

Trista said...

Okay, let's see if I can gather some thoughts tonight. I rounded up some links for resources to check out, and this comment might be disjointed but that's sorta how I'm rolling at the moment. ;)

Ok, first, a few links:
http://kellymom.com/ages/newborn/bf-basics/bf-links-multiples/ (Kellymom is one of my fave breastfeeding sites in general, super helpful, lots of good info, and there's stuff on there related to various issues, such as if you have issues with latching due to small babies, etc, how to TRULY tell if milk supply is low)

http://www.lllc.ca/find-group (I never attended a la leche league meeting however I know women who have and have found a lot of support for breastfeeding. this might be something you want to check out. also, there's a book 'The Womanly Art of Breastfeeding' put out by the La Leche League that's supposed to be phenomenal)

http://breastfeedingonline.com/newman.shtml (Dr. Jack Newman is a breastfeeding guru!! such awesome articles... check him out.. there's also contact info at the bottom of the page.)

a couple more la leche league links:
http://www.lalecheleague.org/faq/twins.html

http://www.llli.org/nb/nbmultiples.html

Our doula trainer recommended to me to tell you to take Gloria Lemay's prenatal classes... can't really find much info on them though, will keep on searching!

As for feeling you wouldn't have enough milk, just always remember that it is supply in demand. If you are concerned about baby's being too small to latch, ensure you have access to a hospital grade pump, or even just use hand expression if that works better for you. supply in demand! keep on emptying, keep on emptying.

Trista said...

(comment was so long I had to do 2!)

support is key. right now, start rounding up people who will support your decision to breastfeed, in any way, helping with housework, helping find out information, making meals so you can have nourishment to nourish your babies, etc.

I know there's some conflicting stuff out there regarding epidural effects etc but I really do believe it can effect breastfeeding, based on the effects of the epidural on mamas and babies (extra water retention due to needing an IV with the epidural can result in swollen breasts which can make latching difficult, if a baby is sleeping and still has the narcotics in her or his system, may have difficulty latching, etc.. and then there's all the connections between epidural resulting in higher rates of Pitocin use and c-sections.. etc, I could go on and on!!) but if you want some links I can find.. there's a book called Obstetric Myths versus Research Realities that comes recommended though I have not yet read it.

I know you said you weren't really comfortable with donor milk, but I wanted to mention it anyway - check out https://www.facebook.com/HM4HBBritishColumbia it is a milk sharing woman to woman group. I've never used it but have heard amazing things if you wanted to go that route! (formula is expensive!)

there's also options for if you do need or want to supplement, but still breastfeed too, like we did. you can use the syringe, tube, cup, etc.. I can go more into this if need be.

if you are really really concerned about your milk supply, but really want to breast feed, there's various herbs you can try to help with that (blessed thistle, fenugreek..) as well as a prescription medication called Domperidone.

ok, I think I am done my spiel for now.. biggest thing is support.. and then all the other stuff will come. birth experiences can and do affect breastfeeding (as you mentioned, and I know you know this stuff! :) so that is something to consider too, doing a birth plan. I think you did with Andy right? even for C-section, can still request to have those babies right up on your chest skin to skin immediately after birth if all is well. one tip I learned is that sometimes they will not let moms breastfeed their babes right away if they have had a c-section, because they cannot feel their nipples and nurses are worried about a bad latch. you can lie tho. and say you can feel your nipples and wanna feed ;) however, that is for our hospital.. your hospital sounds so much more mom/baby centered for SUrE, sounds pretty amazing!

also I am curious why your doc recommends epidural so strongly? just curious! always learning.. :)

as for the doula stuff, yes let me know if you have questions. I am more than willing to go on the hunt for someone who would be able to support you and your family for minimal fees etc.. I wish i could do it! ;)

xoxoxo <3<3!

Elizabeth said...

Thank you SO MUCH for all this info Trista! I really appreciate it! I’m just heading to bed but will have a closer look at the links over the weekend.

I know I’m just worrying about my worst case scenarios, and hopefully everything goes as well as it did with Andrew. I am already starting to produce some colostrum at 20 wks and my breasts are ginormous so I’m hoping that means they’re getting ready for milk production! It’s true though, I’m going to need support…Of course James is totally supportive, and some people around me are, but I find many people saying there’s no way I’ll be able to breast feed twins and I’ll have to formula feed simply because I’ll be too tired and will want someone else feeding at least one baby for me – I don’t think they think about how much work goes into formula feeding, though. It’s a lot more effort than just latching a baby on! If the milk is there, to me it makes sense to just use that. I do plan on buying a double electric pump. The hospital grade ones, from looking into it at BC Women’s, get quite costly to rent (and to buy are over $1000 apparently) but the women who are breastfeeding and pumping in my multiples group (several have had their babies now) have given some recommendations on good pumps. Costly…but I think it will be worth it and I can always sell afterwards. I’m not sure I want to buy used though, but still considering my options! I used my handheld pump so much with Andrew, so I think it makes sense to get the electric kind for twins. More so to keep my supply as high as possible, especially in the beginning, than to have other people feeding the babes for me, although of course there will be times where it’ll be nice to feed one and have someone else help with the other (especially James, for bonding purposes too).

I would totally appreciate you helping me with finding a Doula that wouldn’t be super expensive, and preferably had some experience with twins…Although you are SO busy and I feel bad asking for your help with that as it seems like a lot of research! I will try doing it myself, I’m just not sure where to start! What sort of tips might you have for going about finding the right person?

I think my midwife prefers to automatically give an epidural because a) with twins, even if the first baby is born vaginally, there’s a chance baby B will need an emergency c-section to come out, and time is crucial by that point, so if the epidural is already in they are ready to perform the surgery if need be. And b) If baby B isn’t in too much distress but is breech, they can put their hand right up into the uterus to turn them around or just grab them out, but she said, ‘You’re not going to want us doing that if you haven’t had an epidural.’ I get that, I do…but at the same time I really hate the idea of the epidural. The drug being in my system and affecting the babies and potentially my milk supply aside, truthfully I’m terrified of how long the needle is and the fact it would be sticking into my back and yet I wouldn’t even feel it once it’s in…it just freaks me right out to the point I’d rather feel the horrendous torturous pains of labour! LOL I haven’t talked to my OB extensively about this topic yet since it has been too early in the pregnancy so far, but I think at my appt next week we’ll be addressing some of that stuff, so I’ll get a better sense for her point of view, and see how easy going she is about maybe NOT automatically doing the epidural…I would really like to try to go without, but I also know I have to do what’s best for the babies. It also freaks me out the idea that baby A could come out, and then something could go wrong with baby B, I want to be prepared for whatever might happen so both babies can be birthed and healthy, however it has to happen.

Aaaahhhh, if only I could know how it would all go ahead of time!!


Anyway, thanks again so much for your insights and support, it means so much! XO

Elizabeth said...

PS I am definitely going to work on a birth plan...I had one with Andrew, but not to the point I wrote it out, I just discussed what I wanted and what my worst case scenarios were with my midwife, and she took it from there. But I know this time around it's going to be more important to have something written down - especially since there's no guarantee my OB will be at the hospital when the time comes that the babies are ready. One great thing about BC Women's is that if everything is OK with the babies, it is hospital policy that they have skin to skin contact right after birth, even if it's a c-section. They even encourage fathers to have skin to skin contact early on! And they are VERY encouraging of breast feeding - they will keep us in a few extra days because it's twins and they know more time is needed to get latching going well etc. So I think it's going to be the best place to have the babies, which does ease my mind a bit with all the concerns I seem to have!



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