If you've never had kids, you probably think that breastfeeding is straightforward. If you read books about it, you probably think that there a few things you need to know, but then it will be straightforward. And in fact, for some people it is, but it wasn't that straightforward for us.
We wanted to put the babies to the breast right after they were born, but the obstetrician said that Judy was too sick for that. (We think that might have been a bad choice, because she had quite a bit of uterine bleeding which nursing might have prevented.) Instead we let the pediatricians do their checkups and first nursed the babies about 3 hours after birth.
Their first nursing went well. Judy lay in bed and the twins were propped up with pillows as necessary.
We were in the hospital for 2 days, and during that time we had quite a difficulty with the babies latching on but then not actually sucking. The hospital had lactation consultants (different ones on different days) but they were badly overworked. They each spent 15 or 20 minutes with us and gave us various techniques to encourage the babies to actually suck. These helped somewhat, but didn't really solve the problem.
We went home after 2 days, and Judy's milk came in on the morning of the third day.
Unfortunately, after a day at home, Jocelyn needed to be in the hospital for 36 hours for phototherapy. After a lot of confusion and agonizing we decided to stay home and pump breast milk for her and run it over to the hospital. They fed her that by preference and formula when there wasn't enough breast milk. Mostly she got the milk.
We got very worried about Perry not getting enough milk and getting dehydrated and possibly jaundiced, so we started pumping some milk for him and feeding him with a syringe (without a needle) if he did not feed well. We didn't want to give him a bottle for fear of "nipple confusion", i.e., bottle feeding interfering with breastfeeding. The syringe worked in terms of getting milk into him but wasn't very convenient at all. But after a day or so of that, he really learned what he was supposed to do at the breast and started nursing properly.
When Jocelyn came home from hospital, we put her to the breast and she nursed well. That didn't last, however, and she went back to sitting on the breast but not sucking. After a while, that became chewing at the breast instead of sucking, which not only didn't get her milk but made Judy's nipples very sore. We decided that since she had had bottles in the hospital, we would just give her bottles of pumped breast milk whenever she had not nursed effectively.
So, for their second week after birth, Perry was nursing and Jocelyn was trying to nurse and then getting bottles when she didn't succeed. Lots of people with breastfeeding problems have babies that don't get enough food and grow slowly, but once they got to this point, ours put on weight quite rapidly. The problem was then not that they were getting enough food, but that the process of getting it into them (particularly Jocelyn) was very stressful.
During this time, we were trying to find a lactation consultant who would come to our house and observe their problems. We talked to a number of people on the phone, but they turned out to not really be lactation consultants but rather various kinds of people who will talk on the phone but not see you in person, or lactation consultants who didn't make housecalls. Eventually, at about two weeks, we found Beth Sargent of Needham who did come to see us. She gave us various suggestions, but nothing that immediately worked to solve the problem.
After that we talked to Beth Sargent on the phone and she said that Jocelyn could not be chewing on the nipple if she were latched on properly, because she would not chew her own tongue. So eventually we realized that she was really never getting a proper latch, and we started to pay intensive attention to how she was holding her mouth and tongue. Every time she was on incorrectly, we would either try to fix it by pushing down on her chin or take her off and get her back on again. That process was frustrating for everyone, but it meant that when she was nursing she was doing it right and getting milk and not making Judy's nipples sore. It took a while for her to learn what was a good latch and what wasn't, but eventually she learned to get it right most of the time.
To improve the situation, Judy began pumping every night an hour or so after going to sleep and after the first nursing. That produced 2 or 3 oz. of milk which we could then feed to Jocelyn and Perry in the afternoon when they didn't seem to be getting enough. That process was quite successful at reducing the amount of afternoon and evening fussiness. Sometimes they didn't need the pumped milk and so we were able to freeze it and accumulate a supply for use when Judy went to work.
Once the twins started solid foods, we very rarely needed a bottle in the evening. When Judy was at work, she pumped her usual 20 oz, but the babies didn't need much more than that, because they have lunch now. So we were rapidly developing a surplus. Judy stopped getting up in the night specially to pump, but if she wakes before the babies need her, it's more comfortable to drain off a bit, though usually only 4 oz., to relieve the pressure, rather than trying to pump dry like she used to.
We looked around on the web to see what we could learn about milk banks. There are only a few milk banks in the country. We found references to one in Worcester MA, but it doesn't exist as a milk bank anymore. However, their answering machine pointed us to a place in North Carolina. Judy has gone through their process of becoming a donor, despite being out of state. They don't have any web presence, but you can find out more about milk banking from another bank in Austin TX, which seems to have a decent website. For those interested in donating, you can contact the milk bank in North Carolina at (919) 350-8599.
They say they will accept previously frozen milk, but then they want to know if you took any Tylenol or Advil the day you pumped it, and we couldn't answer that for the quarts in the freezer. So we decided to cycle the milk - when Judy goes to work we defrost old milk, and then she pumps into the special containers from the milk bank, which we freeze. They will also get much of the nightly production. Eventually we will get a cooler from the milk bank, and FedEx our collected frozen milk.
Milk banks serve primarily premature babies who can't tolerate formula, rather than general consumers. In some ways, donating to a milk bank is like giving blood - you have to answer a medical questionnaire and have a blood test to make sure you don't have certain diseases (HIV being a primary concern). Because of this overhead, they require at least 150 oz as a minimum donation. They don't want your milk if your baby is over a year old - apparently there's some composition change that happens around a year. Ours were 7 months when we started the process and will be 9 months when we finish cycling old milk.
We introduced cow's milk at the recommended 12 months, and there were no problems. Interestingly, although cow's milk and breast milk taste significantly different, the babies seemed content to have cow's milk interchangeably with breast milk. We gradually cut back on nursings during the day, and as her production consequently dropped, Judy stopped needing to pump at night and even stopped pumping while away at work. We were done with our "insurance policy" milk, and sent it off to the milk bank (after a considerable delay introduced by them--their freezer was broken so they couldn't take new shipments!) In total, we sent 388 ounces to the milk bank, just over 3 gallons.
Night Weaning: Since December of last year, they've only been waking to nurse once a night. Usually it was Perry who woke first, and to reduce the number of times Judy had to get up and avoid her being lopsided, we would wake Jocelyn at the same time to nurse. Babies are pretty good at waking just enough to open their mouths and then nursing back to sleep.
In early October we tried giving Perry a bottle when he woke and seeing if he would go back to sleep without actual nursing. He was completely happy with this plan. Jocelyn sleeps through the night. We probably could have done this a few months earlier, but before her production dropped Judy would have been uncomfortably engorged from all night, so this was better timing.
We don't yet have plans of when to fully wean. Perry would probably be happy to do it now. Although he likes nursing it's not a huge deal for him. Jocelyn, however, loves nursing and often asks for it, so weaning her would be a challenge. It also makes bedtime and naptime easier---nursing to sleep is surer and less work than singing/walking to sleep. They'll wean before they apply to college :-)
Jocelyn, shortly before turning three, was heard to report that she would wean when she was a grown-up, and then she later consented to wean when she was a teenager.
When they were about 20 months Judy had been nursing them approximately four times a day: once in the morning, once for nap, once in the afternoon either when she got home from work, or just for a pick-me-up, and once for bedtime. Judy says, "the home from work nursing was the one that made me the most irritated, because I would arrive home, and they would start yelling NEENEE NEENEE (their word for nursing). But I wanted to be seen for myself, rather than just for my abilities as a cow."
So we talked with them about how when Mommy comes home from work we're not going to have neenee anymore, but that Mommy would spend special time with them. It hardly took any time at all to get them into this mode. A couple of months later, we similarly dropped the morning nursing. That left just nap and nighttime. And there we were for a year.
Perry could have been weaned anytime. It's a little complicated to wean when you are a twin, because you can go back anytime you want, as long as your twin is keeping up the milk supply. Often at bedtime Jocelyn would be nursing, and we would be talking to Perry about bedtime, and he would first say "diapers, pajamas, and go to bed" and then after diapers and pajamas he would often say "and neenee", and come join Jocelyn. If Judy was not home in the evening, Perry just flopped down on the bed and went to sleep when it was bedtime. Jocelyn needed a lot more help, and sometimes would still be awake when Judy arrived from her outing.
When he got an ear infection shortly after his 3rd birthday he didn't want to nurse much any more. He took a break of a few days, and then we went on a 10 day trip, and Perry joined Jocelyn for nursing only once.
One interesting facet of Perry mostly weaning is that because we have had assigned breasts, Jocelyn frequently had to nurse on "Perry's side". But she still maintained the ownership, and asked whose side she was to use each time.
It sure was convenient to still be nursing at the end of our trip. We were getting on the airplane to come home, and Jocelyn was tired, and she pitched a fit over something trivial. After several tries to get her to calm down and sit in her seat for takeoff, we offered nursing, and Judy nursed her to sleep right there in the plane, before takeoff. We'd been hoping to wait until after, so there wouldn't be any ear issues, but she slept right through takeoff and stayed asleep for the next 1.5 hours, much to the relief of our fellow passengers.
After the long trip, we had a short trip planned, and we had been talking for some weeks about how "after Ferry Beach we will be all done with neenee". Jocelyn appeared to be in agreement with this idea, but when we came back from the trip, and it came time for bed the first night, she asked for nursing. We inquired "weren't we going to be all done with that?", to which she responded something equivocal. She nursed to sleep that night. Eventually we made some agreement about a certain day, which coincided with a big summer bash at our house (although we did not bill it to her as a "weaning party"). It was convenient to disassemble the nursing couch during the party and have it be used as a sitting couch, and so we just proceeded as though we were really going to be all done on that day, and sure enough, we were!
Perry was a little unhappy about Jocelyn actually weaning, even though he was pretty much weaned, because he asked to to nurse three nights running at the end. But Perry doesn't like things to change, even when they don't affect him much, so this isn't really surprising. Jocelyn seemed to be completely OK with it a week later; there was a little pretend game she was playing, and she said "only people who are weaned can play this game." Last nursing was August 20, 2005, for both of them. 3 years and 30 days old.
Jocelyn and Perry home page