Surrounded by Love
By Renee Coscia
White Plains NY USA
From: NEW BEGINNINGS, Vol. 21 No. 2, March-April 2004, p. 51-52
As the days move closer toward the third birthday of my twins, Jake and Rebecca, I cannot help but reflect back on the past three years of our lives together. Despite the range of emotions we have experienced, I never could have imagined the irreplaceable joy they have brought into my life.
The day my midwife told me I was expecting twins, I fell into a panic. It was the greatest surprise of my life. I have no idea how I drove home from her office. My mind fell into a whirlwind of thoughts and emotions. It was hard to lay to rest the dream of a home birth. Would my body be able to safely grow and carry two babies? What would my labor and delivery be like? What would happen if I needed a cesarean? How would this affect our little family—especially our daughter, Emily, who had just turned four years old at the time? What would my life be like raising twins? Would I be able to nurse two babies? My husband, John, was there for me the whole time, encouraging me and reminding me of how strong I was.
When my first child, Emily, was born, I recalled being worried about my milk supply. She gained weight just fine, but she seemed to nurse all the time. My nursing experience was unlike the experiences of my friends. My breasts never became engorged, not even initially. I never really knew what day my milk "came in." I never leaked milk and never needed nursing pads. My breasts seemed rather small and soft. So I worried through the entire pregnancy with the twins. Would I be able to do it? During the pregnancy, I spoke with several LLL Leaders and lactation consultants to help me prepare. Everyone was supportive and understanding and said they would be there to support and help me.
Jake and Rebecca were born just shy of 38 weeks on a Sunday afternoon. My labor and delivery went very well. A dream birth for twins -- no medication or stitches! Jake, who was almost five pounds, was born first and then came Rebecca, who was a little over six pounds. Rebecca was initially breech and then turned her self around (with a little help from the midwife) as I was delivering Jake. In my eyes, one milestone was met with great success. Was I up for the next challenge?
Both babies nursed right after birth, but I noticed that Jake did not seem to latch on well, nor did he suck for any length of time. It was also very difficult to wake them to nurse. No one in the hospital was of much help. There were 19 babies born on the same day and the lactation consultant was nowhere to be found. I was exhausted and emotionally overwhelmed. On one hand, it was a pleasure to be able to go home a day later; on the other hand, I was scared out of my mind.
At home, Jake and Rebecca’s nursing sessions weren’t going very well. Within a few days, both of my babies seemed a bit jaundiced and drowsy. It was just about impossible to wake them up. When they did nurse, it was for a short amount of time. On day five after their birth, I had a lactation consultant come to work with me at home. She helped me coordinate nursing both babies and assisted me in encouraging them to suck longer throughout the feeding. After she left, I thought things were headed in the right direction.
My pediatricians were very supportive of my desire to exclusively nurse my twins and trusted my instincts and judgments. We went into the doctor’s office frequently for weight and jaundice checks. Early on, we noticed that the babies weren’t losing weight, but they weren’t gaining much either. Jake and Rebecca were in a holding pattern.
I was not overflowing with milk and became concerned about establishing a supply for two babies. Even though I was pumping, I never was able to obtain a great deal of milk. I tried herbs and drugs. I supplemented my frequent and brief nursing sessions with donated milk and some formula. We tried finger feeding, syringe and tubing, and the supplemental nursing system. I was so afraid to use a bottle. If they were having trouble latching on to begin with, bottle-feeding might be so much easier for them and then I would never get them back to the breast. No matter what I tried, Jake and Rebecca seemed to tire quickly and continued to gain at a slow rate. Nevertheless, my pediatricians were supportive and encouraged me to continue if I felt up to it. I was determined to make nursing work. Through my experience with Emily, I knew the benefits of breastfeeding and the bond forged by breastfeeding.
I saw three different lactation consultants. Each expressed different theories about what was going on. The jury was out -- was it the fact that I could not produce enough milk or were the babies having suck problems? Upon assessing Jake’s mouth, one lactation consultant actually recommended he have surgery under general anesthesia to reconstruct the area under his tongue so that he could nurse more effectively. She told me that if he could not suck effectively, he would more than likely develop poor speech habits as well. I was devastated to think that my baby, who was a mere eight weeks old, might need to go under general anesthesia. What was a mother to do? I decided I would look elsewhere for help.
Exhausted from lack of sleep and a nursing schedule that seemed to consume my every waking moment, I was on the verge of a breakdown. My family was suffering. I was sleeping sitting up so that I could comfort both babies in the middle of the night and my husband was sleeping in the spare room. He was so supportive of what I was doing, but he saw the toll it was taking on all of us. I wasn’t able to meet the needs of Emily in the way that I wanted to. It wasn’t going the way I dreamed it would. My routine was exhausting me and I was beginning to break. This had to end.
At one of our frequent pediatrician visits, my doctor suggested I see one more person whom he trusted explicitly in her expertise regarding breastfeeding. I first spoke to Laura Best-Macia late on a Saturday night as my husband and Emily were camping out in the backyard. She listened to my concerns and in just that one telephone conversation, I knew she was going to make the difference. Laura’s office was located in Manhattan, an hour drive from our home. A few days later I packed us all into the car and off we went into New York City.
Laura was terrific with me from the start. First off, her calming manner and soft voice put me at ease and I was able to trust her. She took one of the twins in her arms gently and watched me nurse the other. She changed their diapers and weighed them. After we talked for what seemed like hours, Laura simply told me I was in a state of overdrive and gave me explicit directions of what I was to do until I would see her again the following week. She truly believed in me and my ability to nurse my babies. She talked to me about my crazy routine and convinced me that I had worked myself into a stage of hyper vigilance that was getting in the way. She believed their latch-on wasn’t all that bad and that I was essentially pumping what they could get on their own, even if it was just an ounce or two at each pumping session. She reminded me to watch my twins for signs of true hunger and not to fall into a routine of nursing them every hour. So at three months of age, the babies and I continued to see Laura on a weekly basis and I was able to slowly cut back on my routine until I was nursing my babies exclusively. I couldn’t have done it without her. When all the other lactation consultants asked me what method or techniques she used, I said trust and understanding. She was like my mother, or a friend sharing her expertise in nursing in a way only an experienced mother or friend could do. In the end, my La Leche League friends celebrated my success with a party.
Three years later we are still nursing. So when I look back on these past few years and all the trials and joys we have experienced, I think of how strong all this has made me. I am confident. I am a mother surrounded by love. In those early months, some friends and acquaintances tried to talk to me about giving up my dream of nursing twins. Some called me crazy. I say I was determined and driven by love.
Note from Laura J. Best-Macia of Wellcare, Inc.: Rebecca and Jake’s performance on the breast didn’t reflect their skills (as determined by my assessments). This enabled me to identify that Renee’s stress level was a significant factor in her continued breastfeeding difficulties. My recommendations were based on the assessment and history gathered at our appointment and my plan to provide close follow-up. I was glad to assist another mother in achieving her breastfeeding goals.