If at First You Don't Succeed
Cincinnati, Ohio, USA
From: NEW BEGINNINGS, Vol. 12 No. 4, July-August 1995, p. 119
We provide articles from our publications from previous years for reference for our Leaders and members. Readers are cautioned to remember that research and medical information change over time.
When my husband, Brad, and I discovered I was pregnant, we decided that we wanted our baby to be breastfed. A few months later, when we found out I was pregnant with twins, we became unsure about that decision. But at a childbirth class for parents expecting multiples, we learned that it is possible to exclusively breastfeed twins. At that point, we again decided that breastfeeding would be best.
After three months of preterm contractions, I delivered two girls, Kathleen and Elizabeth, five weeks early. Kathleen weighed 7 pounds, 2 ounces. Elizabeth weighed 5 pounds. Both girls were taken to the Newborn Intensive Care Unit (NICU) shortly after birth because of concerns about immature lungs. A few hours later, a home care nurse who visited me reminded me of my decision to breastfeed and told me to ask someone at the hospital for an electric breast pump to use during my stay. Thanks to her, I began pumping a few hours after the girls were born. Since I had to leave the hospital before the girls were released, we rented an electric breast pump on the way home.
While Kathleen and Elizabeth were in the hospital, I pumped at home every two to four hours, including at night. I brought the milk to the hospital for the nurses to feed the girls. I also told the NICU staff that as soon as each girl was physically able, I wanted to breastfeed them during my visits. The hospital policy was to feed the girls bottles of either breast milk or formula when I was not present.
My breastfeeding attempts in the hospital were frustrating. Since the NICU was crowded, there was little privacy for the girls and me to learn to breastfeed. In addition, to avoid disrupting the girls' feeding schedule, I was given only a short period of time to try breastfeeding before the nurse would offer each baby a bottle. Even though bottle-feeding began to look easier than nursing, I decided to keep on pumping breast milk and to begin breastfeeding Kathleen and Elizabeth once they came home.
After two weeks in the NICU, Kathleen and Elizabeth were released. Both girls had lost some weight in the hospital, so the pediatrician recommended I keep bottle-feeding them to monitor how much they were eating. I developed a routine of pumping breast milk prior to each feeding, putting a nipple on the collection bottle, and bottle-feeding each child. During the day, this routine was bearable but at night, it added about twenty minutes to each feeding. In addition, I had all those bottles to clean, and both the girls and I were missing many benefits of breastfeeding.
So I tried breastfeeding Kathleen and Elizabeth several times a day, but was unsuccessful. They each would chew on the nipple but didn't suck or swallow. After about thirty minutes, I would give up, pump, and feed them a bottle. They would then chew on the bottle nipple. It would take them a few minutes to remember how to use the bottle. Those feedings were miserable for all three of us.
After four weeks of pumping, I called La Leche League. I spoke to Karen Gromada, a Leader and certified lactation consultant, who had breastfed twins and had written a book on the subject. I was unsure how much longer I could handle pumping and bottle-feeding and was also not certain Kathleen and Elizabeth would ever learn to nurse.
Karen told me that the girls were nipple confused but could still learn to nurse. She suggested two options. I could try a transitional method of feeding, i.e., cup-feeding or syringe-feeding, or I could convert to breastfeeding cold turkey. She recommended I work with one girl at a time and chart how often each ate and produced wet and soiled diapers. Then I spoke to a different pediatrician who supported my decision to breastfeed and agreed with Karen's recommendations.
I began with Kathleen. For an entire day, I exclusively breastfed her and pumped milk for Elizabeth. During most of her nursing, she chewed and did not swallow. That evening Kathleen began crying uncontrollably. I was unable to get in touch with Karen and panicked. Nothing would console Kathleen. I finally gave her a bottle, and she drank about half an ounce and went to sleep. I decided I failed at breastfeeding and gave up.
The next day, Karen called and asked if I was still trying to breastfeed Kathleen. I said I assumed that since I had given her a bottle, I should stop trying to breastfeed. She asked me if I still wanted to breastfeed the girls. I was tired and confused and did not know. Karen put no pressure on me but suggested I make a decision I could support several months later. At that point, I knew I would be disappointed if I gave up breastfeeding.
I waited until the weekend to try again. My husband offered to take total care of Elizabeth so I could devote my time to working with Kathleen. Late Friday afternoon, I began breastfeeding Kathleen. That evening, it took a bottle to get her to stop crying and go to sleep, but that was the only bottle she had that night. On Saturday morning, Karen came to the house to help me and by Saturday evening Kathleen was nursing quite well. The following Monday, I began nursing Elizabeth, and the process went much more smoothly. By Monday evening, both girls were exclusively breastfeeding.
Kathleen and Elizabeth are now seven months old. They are both wonderful nursers. I never regretted my decision to breastfeed. All those hours of pumping were worth it.