Kristen Ross is a Mother Wit mama who I had the of pleasure of working with through her third and fourth trimesters. She has 16-month-old identical twin girls now and has recently become a postpartum doula through Erica Davis’s Whole body pregnancy. So, if you are in L.A. and in need, you can find her at @twin.postpartum.doula on Instagram or visit her website to learn more about her services.
When the babies were born at 36 weeks, one baby was in recovery with me, Dani, and the other baby was in the NICU for the duration of the time we were in the hospital, Gaby. Thankfully, she had a very quick recovery and we were able to go home together on day 5 postpartum. That meant I had one baby with me who could attempt nursing on a regular basis and one baby who could only attempt to nurse when I was in the NICU. I had a really rough recovery from my C-section and I was very immobile. The entire five days in the hospital, I was only able to go to the NICU twice. The rest of the time Blake, my husband, spent a lot of time in the NICU because I just couldn't. That was really hard.
So, I had tiny little preemie babies born a month early, one in the NICU and one with me, and as you can imagine, nursing was not very successful in those early days. I made attempts at every feeding but it was mostly hand expressing into Dani's mouth and then her licking up a little bit of it and then me giving her a bottle. I came into this feeling fine about using formula. I couldn't put all that pressure on myself to exclusively breastfeed so we introduced formula for both babies by day two. I was doing the best I could and I wasn't going to stress too much about it. I started pumping in the hospital so I could work on getting my milk to come in. Once it did, I had to relieve engorgement because a baby was not doing that for me. I got into the routine of “triple feeding” where we would try and nurse and then we'd give the baby a bottle and then I would pump and that would happen at every feed, every three hours. The lactation consultant who sent me home said, “Okay, so triple feeding twins is gonna be a lot for you. So, you know, just make sure you take it easy on yourself.” And I was like, okay, whatever, I've been doing it for five days in the hospital, it's fine. I've got a routine down. And then I realized that I was doing it in a hospital where someone's delivering me my food, checking on me around the clock, taking care of me AND I only had one of my babies with me. Of course it was going to look way different once I got home! It was immediately unsustainable and I absolutely could not do this at every feed.
I worked virtually with a lactation consultant, Dana Hilsenrath. She is an awesome lactation consultant out of Westchester county, New York. Her practice is called Westchester Lactation. She's also in Thriving After Birth, Tanya's online postpartum course, and she is a twin mom who had babies in the NICU too so she brought a really personal expertise. The virtual work that we did together was really helpful mostly because, as a twin parent, she was able to very realistically explain what the next few days were probably going to look like. She talked me through some pumping and scheduling stuff. I remember that she said, “Listen, triple feeding twins, you're not gonna be able to sustain this, especially because you don't have extra help at home. It's you and your partner and that's it.” She's like, “So here's what you need to do… You need to try nursing once a day. That's it- attempt to nurse the babies once a day. Then, if you're up for more, awesome, if not, try once a day and that'll be enough to keep bringing those babies to your chest. Other than that, focus on just pumping and feeding your babies.”
Tanya chiming in here: We need to think about this more when babies are born preterm, we want to think about them in terms of their gestational age and not in terms of their birth age. When Kristen had two week-old babies, we should think of those babies as negative 2 weeks. And that helps us understand what babies are capable of physiologically and it allows us cut ourselves some slack, so to speak, because we start to say things like, "Well, why can't I get this right?" Or, "Why can't my baby do this?" But, if you think about the fact that your baby should ideally still be inside being fed through its umbilical cord, we can give ourselves and each other some grace around what's happening.
Any attempt at nursing was exhausting for them. Not getting their food delivered through the bottle was so tiring for them so we set realistic expectations. We decided to do what Dana suggested, to try nursing once a day. And even that, which seemed really rational and reasonable, was not sustainable for us. It was so hard and so exhausting. At that point I was focusing on pumping and was planning to come back to nursing later. I was in survival mode where I needed to get milk out of my body. I needed to get milk and formula in their mouths. I was going to do that in the most efficient way possible, which was pumping.
When the twins were about a month old, I had a lactation consultant come over, who also is a mom to twins. She was able help me with pumping. I was using the hospital pump that I'd rented and I wanted to try and switch over to my other pump. I was overwhelmed by the idea of having to switch up anything about my process. She came in and told me what I was doing right, what I needed to tweak. She was super helpful. And then, I had her come back to help me with nursing. I actually tandem nursed my twins with her assistance. It was an extremely special experience. I get very emotional thinking about it. So, we did one tandem nursing session. It was beautiful. I took pictures and I will remember it fondly forever.
Silverettes. I call them nipple caps. They're made of silver and you just like pop 'em on top of your nipples to give them a little bit protection and allow time for healing. Most people use them when their nipples are raw, temporarily. I used my silverettes every single day for the rest of my breastfeeding journey. With exclusively pumping, my nipples were so sensitive all the time. It wasn't painful, I wasn't pumping too hard, they were just so sensitive. Any fabric touching my nipples was really uncomfortable. These saved my breastfeeding journey.
You might need more than one pump: I started with a hospital grade pump that I rented, then switched to Spectra, and then worked in the Hygeia Enjoye and Elvie pumps. Ultimately the Baby Buddha pump became my primary pump. Most people get a Spectra or Medela through their insurance company. The others, you can get hand-me-downs or used and just purchase new parts. The Hygeia Enjoye I actually really loved and it uses Medela parts so it was very easy for me to transition. I used the Elvie pump for a while because I wanted to try and be more mobile, because it's very hard to take care of two babies while being attached to a pump. However, I was not a huge fan of the Elvie in the long run because of the difficulty in getting a proper seal. Some people have success with it but I don't think it works well as a primary pump. You're definitely not going to get the same output as you would with a standard pump. The Baby Buddha pump ended up being my favorite pump of all! It has the mobility of an Elvie or Willow (it's about the size of a cell phone) but the strength of a Spectra or Medela. It's important to remember that it's a gradual process of figuring out what pump serves you best at what times. My tip to folks is to ask around your friends to see who has pumps laying around they're not using. So many people have an old Spectra sitting in a closet because they're done with their breastfeeding journey but don't know what to do with a used pump.
The wheely cart: these little three tier carts you can get from Ikea or Target. They make great pumping stations! I had mine set up so all I had to do was sit down on the couch and wheel it over and I instantly had all my pumps ready to go. Everything was plugged in on the cart so that I didn't have to mess with wires or anything. I had snacks, nipple butter, pump lubricant, lotion, you name it! Anything that made pumping a more pleasant experience was stored on that cart.
Self-care during pumping sessions: physical comfort is key to success! When you are pumping, It's so easy to hunch over and sit leaning forward and look at your phone. We so often set ourselves up in really uncomfortable positions that are not serving us in the long run. I had pillows set up in the right configuration to make sure that I was sitting as upright as possible. I got myself a phone tripod so that I could watch things on my phone without holding it. I had a set of sleep headphones: They are very comfortable fabric headbands with headphones inside. I used these instead of earbuds. It was nice and comfy around my head. And then there was the foot bath. Very elaborate, I know, but it absolutely worked, being more comfortable was key to my success. It was restorative as opposed to draining. Tanya chiming in again...That's really important because if you are gritting and bearing it, you are promoting an optimal hormonal profile that promotes optimal milk production.
Stop counting ounces. The more you stress out about the ounces, the more stressed you will be and that can make it harder to have a let-down. I just stopped tracking my output altogether. There are apps that let you can track how much you're pumping every session but I found that any amount of tracking would send me into a tailspin.Tanya here...One of the tricks is baby socks over the bottles. Don't even look at the milk as its coming in. Just wait until you're done pumping to figure all that out. There's a place for data in the early days, but even then we're looking for patterns. Whether we're talking about pees and poops or our milk supply, we're looking for patterns and one anomaly does not make a pattern.
Tanya's bonus tip: Stay curious, keep the spirit of experimentation alive, play detective. Things are constantly changing and evolving literally dad by day.
The take away according to Kristen: I see the big gap in postpartum care and that why I love being a postpartum doula. There's a massive gap in people not preparing for postpartum, not thinking about postpartum, having bad experiences because they didn't know what to expect and they don't have people to support them.
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