How Do You Make Enough Milk for Two Babies?

At my Richmond Area Mom’s of Multiples (Ramom) meeting the other night, a fellow twin mom said, “I wish someone had told me that I might not produce enough milk.” Statements like this are not uncommon, and we spend a solid portion of every meeting talking about nursing. It’s obviously something that every mother is concerned about. I’m not a lactation consultant, but having nursed my daughter for 15 months and nursing twins for more than three months now, I think there is something I can add to the conversation. Plus people have specifically asked me questions about nursing, and if one person is wondering, chances are a bunch of people are wondering. So here it goes.

“How do you make enough milk for two babies?”

Most of the literature on human lactation will tell you that it’s about supply and demand. The more you nurse/pump, the more milk you will produce. They tell you to let your babies nurse whenever they want to. Don’t give them pacifiers. Let them comfort nurse instead. And if you leave your babies for more than a couple hours, bring your pump so you can express your milk every two to three hours.

Ok supply and demand. Simple and sensible, right? Well the reality is more complicated than that. I'm going to break this problem down into some of it's components.

When Your Milk Comes In

When your babies are born, what you have to offer is colostrum, not milk. If you deliver in a hospital, you'll quickly get sick of all the nurses and doctors asking you if your milk has come in, yet. This early stage of lactation is NOT controlled by supply and demand. Rather it is triggered by the birth of the placenta and is driven by hormones. If a mother chooses not to nurse, her milk will still come in. This is important to know. Usually your milk comes in within a couple of days, but if it takes five days for your milk to come in, that is NOT your fault! 

The Biology of Lactation (Get Ready for Some Jargon!)

Once lactation is established it is driven by supply and demand. Prolactin is the hormone that stimulates milk production. In order to do that, it has to attach to receptor sites on milk-producing cells (lactocytes). When these cells are full, the receptor sites get stretched and misshapen, so prolactin can't attach properly (Read: Full boob = less milk production). So the key to stimulating more milk production is to empty those lactocytes often! 

Frequent and Effective Expression

Nursing often isn't always enough. If you want to boost your milk production, your babies have to be emptying (or almost emptying) your boobs when they nurse. If you've got a singleton, offer both boobs at each feeding. (If you have twins, you're doing that anyway.) You may want to do some breast compression while you're nursing/pumping to increase the milk transfer. If your babies aren't emptying your breasts during a feeding, you may want to pump immediately afterward. 

Storage Capacity 

No, that's not a euphemism for boob size. A large-chested woman can still have a small milk storage capacity. However, a small storage capacity does not mean an inability to effectively nurse. It just means your boobs will get full more often, and therefore you'll have to nurse/pump more often than your large-storage-capacity sisters. If this applies to you and you want to boost your milk supply, you may want to include pumping sessions between feedings.

What You Eat

Some women eat lactogenic foods or take supplements to increase their milk supply. I've never noticed a change in my milk production after eating anything specific, so I can't vouch for this. If it works for you, then great!

Your Support System

For me, this is the key. It's all well and good to say, "Nurse often, and if that's not working, pump more!" But there are only so many hours in the day. While you're glued to the pump, who is going to take care of your toddler and wash all the burp cloths? When my twins were a week old, I posted this as my Facebook status:

Postpartumly crying about how great it is to have my whole family nearby. I spend so much of my day nursing, but I CAN do that right now because my family is taking care of everything else for me. Clean laundry appears in my room and food is brought to my table.

My mom stayed with me for eight weeks! Some new mothers have to go back to work before eight weeks is up. And then they have to find a way to pump and store breastmilk at work! I can't even imagine.

I have so many feels for women who don't produce enough milk. When I think about my ability to feed my babies, I don't feel superior. I feel lucky. I know too many women who did everything right, but the stars just didn't align for them.

Bottom Line: You might not produce enough milk, but lactation is complicated. Please please please don't feel guilty about it. 

Revised Schedule

So I've been trying to establish a schedule. The schedule I chose was based on a book called What to Do When You're Having Two. It is a somewhat helpful book, but this schedule is not working for me at all, mainly because it calls for two nap times: a morning nap at 9am and an afternoon nap at 1pm. My boys, however, are ready for their morning nap before 9am, and they are ready for their afternoon nap before 1pm. 

I just read a lovely article by Christy Brunton, author of Sleep Training for the Exhausted Mom. In the article, she mentions the two-hour wake rule which is that babies cannot be awake for more than two hours without needing a nap. Ah ha! There is a universal law to describe the phenomenon I've been experiencing! Brunton also mentions that four month old babies should take three naps a day. With that in mind, here is my revised schedule:

6am - Twin Feeding
7am - Breakfast with Miss Two
8am - Twin Feeding and Nap
9am - Morning Snack with Miss Two
10am - Twin Feeding
11am - Lunch with Miss Two
12pm - Twin Feeding and Nap
1pm - Miss Two's Nap
2pm - ME TIME
3pm - Twin Feeding
4pm - Miss Two's Outside Time
5pm - Twin Feeding and Nap
6pm - Family Dinner
7pm - Twin Bathtime
8pm - Twin Feeding and Bedtime for everyone

Altogether that's seven twin feedings. That sounds pretty reasonable to me. The key is flexibility of course. If the twins wake up at 9am then they will want to nap again by 11am, and that's fine. I'm not going to try to keep them awake for more than two hours. That's my new rule. 

Wish me luck with my new schedule!

Establish a Schedule or Embrace the Chaos?

The twins are three months old now, and Big Guy is even sleeping through the night (WOOHOO!) which means it might be possible to get them on a schedule. Up ‘till now, I’ve been embracing the chaos (or at least trying to). I’ve said to myself, this is what my life is right now, and I’ve rolled with it. Newborns should be able to nurse on command. They should be snuggled as much as they want. When you agree with these sentiments and you have twins, it means you are basically constantly nursing and/or snuggling a baby.

A schedule would be nice. A schedule might mean more sleep for everyone at night. It might mean more alone time for me in the afternoons while all the kids are napping. It might mean more chores get done or more puzzles with Miss Two!

Here’s the thing though, I’m not very good at getting babies to adhere to a schedule. Most schedules require sleep training (leaving the baby in the crib to cry it out), and I don’t feel comfortable sleep training my three-month-olds. Most schedules have set feeding times, but when a sweet little baby nuzzles me for some comfort nursing, I always give in. Most schedules for twins assume you’re feeding them at the same time, but Big Guy is getting too big for the nursing pillow. I’ve started feeding them separately.

Still, I really want to give this scheduling thing a shot! So here is what I’m going to attempt:

6am - Wake up and breathe and brush your teeth before you have to feed the twins

7am - Breakfast with Miss Two

8am - Twin Tummy Time

9am - Feed the twins and put them back to sleep

10am - Chores and/or puzzle time with Miss Two

11am - Feed the Twins

12pm - Lunch with Miss Two

1pm - Afternoon nap for all the kids

2 to 4 - ME TIME!!

4pm - Feed the twins

5pm - Family dinner

6pm - Bath Time

7pm - Feed the twins and put them back to sleep

8pm - Miss Two’s bedtime

What do you think? Is it feasible? I started it last night with baths at 6pm, and it worked well for the twins. They were both deeply asleep before Miss Two’s 8pm bedtime. This morning was a different story, though. Little Guy woke up and nursed at 5am, so right off the bat, he and Big Guy were on different feeding schedules. It was a bit chaotic, but I did manage to get both of them to sleep at the same time for a little while. It allowed Miss Two and I to play with her alphabet puzzle.

Miss Two was also very generous and cooperative with nap time. She got in bed all by herself at 12:30 and was asleep by 1. It was pretty great. Big Guy fell asleep around 12:15, and Little Guy fell asleep around 1:15. So the kids are not quite on the same afternoon nap schedule yet, but we’re getting there.

It’ll be interesting to see if I can get this schedule to work or if I’ll have to make adjustments. I’ll keep you guys posted.

7 Reasons SAHMs Need Girl Time

If you are a stay-at-home-mom, here is my best advice for you: Get out of the house. As soon as possible. Call your bestie, pump some bottles for those babies, and go. Seriously, you need some girl time. Here are the seven reasons why:

7. Your house smells bad (poopy diapers). You smell bad (spit-up). Fresh air smells good. Your bestie smells good. Your nose deserves to smell good things now and then.

6. Girl time is calm. Your girlfriends might not let you pee alone or eat a meal without sharing, but they also won’t pull your hair or scream in your ear or say “Mommy! Mommy! Mommy!” incessantly. Calm feels good, remember?

5. Your bestie misses you. She adores your children. She’s so proud of the mom you’ve become. But she also just wants to hang out with you sometimes. You can give her some of your time, can’t you?  

4. You need to learn the meaning of the word trust. You can trust your spouse to watch your babies. You can trust your mom to watch your babies. You can trust in the resilience of your children. They will survive without you. But you won’t know that for sure until you test it.

3. It’s way too easy to isolate yourself. Making plans is difficult. Your life is chaos. It’s a lot easier to succumb to the chaos and the isolation than it is to make plans and stick to them. But the easy thing is not always the healthy thing!

2. You are more than your relationships. Yes, you are a wife and a mother. Yes, those are wonderful titles to claim. They are beautiful, integral parts of your identity. But you are also more than that. Your bestie knows what I’m talking about. She can help remind you.

1. Motherhood can be incredibly lonely. You’re at home all day every day with no adults to talk to. Maybe facebook is helpful. Usually it is not. Maybe you’ll get to talk to your spouse when he/she gets home. Probably you’ll be interrupted by your toddler a hundred times. Don’t let motherhood be lonely. Reconnect with your female friends and be reminded of the sisterhood that you are a part of.  

Stay-at-home-moms, I know it's not easy to make plans with your girlfriends. I know you're uneasy when you leave your babies, and you can't even find time to shower. But I hope I've convinced you of the importance of girl time. Drink wine or carve pumpkins or get sunburned. It doesn’t matter what you’re doing. It matters who you’re doing it with.

My Daughter Likes Cars

My daughter likes cars. When she was almost 2 years old, my husband and I bought her some pajamas with cars on them. She was happy with her new pajamas and immediately wanted to put them on. However, she did call them 'boy jamas', and I was shocked. How did she already know about gender norms? Weren’t we being pretty gender neutral with her?

I like the idea of gender neutral parenting. I think it produces more well-rounded kids, kids who are more true to themselves. I want my kids to pursue things they actually enjoy rather than limiting themselves to things that they perceive to be in line with their gender.

In reality, however, I’m not raising my kids in a truly gender neutral way. This past Easter, for instance, I put my boys in ties and my daughter in a dress. If, in the future, my boys want to wear dresses on Easter, I know I will cringe before I say yes.

Here's the thing though: I know that I dress them this way because babies in ties are adorable and toddlers in frilly dresses are adorable! I know that if my sons want to wear dresses I will cringe not because there's anything wrong with them wearing dresses, but because of the probability that they will face ridicule.

I absolutely want my kids to break gender stereotypes. I also don't want them to be bullied. So until it becomes socially acceptable for boys to wear dresses (or until my boys start choosing to wear dresses) I'll keep putting them in ties.

In the meantime, here are some of the ways that we are getting it right:

1. For Christmas my nephew received an awesome toy car that lit up and had sound effects. My daughter definitely tried to steal it from him. That following Monday my sweet husband went to a toy store after work and got her one like it.

2. My boys will sit in a pink high chair, because that is the color of the high chair we own.

3. We watch all the kids movies/shows with Miss Two, not just the princess ones. Not surprisingly, some of her favorites are Thomas the train, Mater from Cars, Curious George, and Totoro. Because those are all really great characters who just happen to be male.

4. Miss Two wears a variety of underwear, from cars to hello kitty to plain old white. My very thoughtful mom bought the cars underwear for her from the boys section of the store, and my daughter loves to tell us when she is wearing “Mater on my butt!”

Admittedly it is pretty easy to be gender neutral with a two-year-old girl, for one glaringly obvious reason: It is much more socially acceptable for a girl to do masculine things than for a boy to do feminine things. If our daughter cuts her hair short when she’s older, people will probably say, “How practical! She is running around a lot and probably getting hot after all.” But if my boys want to have long hair, people will probably, at the very least, ask them why they don’t get a hair cut.

I honestly don’t know what I’m going to do about my sons’ hair. I’m sure there will be a variety of other situations in the future that I have not even considered wherein gender norms can either be adhered to or broken. I guess we’ll cross that bridge (and probably blog about it) when we get there.  

P.S. Here's a blog post I like about gender written by a Dad
and here's a strongly-worded (read explicit) spoken word poem about the phrase 'man up'.

Date Night

One Friday at lunch time my sweet husband asked if maybe we could go out on a date in the evening. I wish I could say that the prospect of a spontaneous date filled me with warm, fuzzy, romantic feels. The reality was that I now had to deal with the frustrations of finding babysitters and making time to pump bottles and grab a shower.

At this point you might say to yourself, how thoughtless of your husband! Doesn't he know that dates take planning and that asking for a date will cause you frustration?

Of course my husband knows this. He's not oblivious. It's just that on this particular Friday he actually felt good enough to go on a date. You see, he's sleep-deprived, too. More often than not, he comes home from work EXHAUSTED.

We had tried to have two other dates before this one. We had concert tickets that we bought before the kids were born, but when the day of the concert came around, my husband opted to stay home and get some sleep instead. On our second attempt at a date after the birth of the twins, I dragged my husband out for a night on the town, and he ended up having a miserable time because he was just so tired.

So when my husband actually asked for a date, I obliged. I spent the afternoon texting every responsible adult I knew in the whole city and managed to get two babysitters. (I don’t like to leave all three kids with just one person.) Then when Rob got home from work, I had him watch the kids for a bit while I pumped bottles, showered, and got ready.

Needless to say I was frazzled by the time we got in the car, but he knew it, and he thanked me for putting forth the effort to make this happen.

For our date, we didn’t do much of anything. We went to the mall and walked around aimlessly like we did when we were teenagers and first dating. We ate at the food court and window shopped and generally pretended we had no responsibilities. It was lovely.

We also spent a good amount of time holding hands and expressing our appreciation for each other and actually looking at each other.

That last part sounds strange, right? But it’s true. I rarely look at my husband anymore. The other day he trimmed his beard and I didn’t notice for two days. The kids have all of my attention. I have conversations with my husband while passing him in the kitchen.

And that’s why it was worth all the frustration to put together a last-minute date. Because I need to actually look my husband in the eye when I talk to him. I need to tell him I appreciate him. He deserves that.

I don’t know how often I’ll be able to go on dates with my husband in the next few months, but whenever he asks for my time, I will try my best to give it to him.