Hindsight is 20/20, and I’ve learned a lot in the last 7 weeks that might have made my breastfeeding experience much more successful.  While I still occasionally try to nurse, we’re pretty much a pumping exclusively and formula feeding family due to a variety of reasons, but primarily: (1) low supply, (2) inefficient nursers, (3) time required to breastfeed twins, supplement with a bottle of pumped milk or formula, and then pump for the next round, and (4) early worry about how much the babies were eating and how much weight they needed to gain.  As a first-time mom, it’s hard to know what you should and shouldn’t do, what to fight for and when it’s right to give up a battle, but if I could go back and do it all over again, there are a few things I would do differently.

1.  I would have pumped more often for longer periods in the first 2-3 weeks.  From the night of delivery, I breastfed Lil’ Brother on the NICU’s schedule of eating every three hours.  I wasn’t allowed to start nursing Big Brother until the next afternoon, but then I breastfed him on the same schedule.  Lil’ Brother was a champ nurser, but Big Brother really struggled.  At 36 weeks, he just still had a little bit of developing to do.  It was about 2-3 weeks after delivery that he really started eating well.  I thought that if I just nursed them every time that my supply would naturally increase as they became hungrier and started eating more.  If I could go back, I would have pumped every single time after they ate, plus a couple extra times a day.  Plus, they were so little, that they ate very little each, and I think I needed additional time pumping to cue my body up for feeding two babies.  I also had no idea how long I should be pumping when I did pump, so I would only pump for 5-10 minutes before my milk came in.  After my milk came in around day 5, I only pumped until the milk stopped flowing.  Now I know it would have been better for me to try to pump at least 15-20 minutes each time.  I definitely should have been pumping for at least a few minutes after my breast was empty to signal my body to up production.  The boys were only nursing for a very short period of time, and the doctors wanted us to supplement, which decreased the time the boys would have nursed even more. In my ignorance, I didn’t realize how important it would be for me to pump, pump, pump to jump start my body to produce lots of milk because by the time they came home with us, they were wanting to eat far more combined than my body was producing.

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2.  I would have further questioned the doctor’s recommendation to supplement.  The boys were born at just over 4 pounds and just under 6 pounds.  I delivered at 8:30 p.m., and at rounds the next morning at about 10:00 a.m., the doctor said she wanted us to supplement with either formula or donated breast milk.  At the time, I was so distraught about my little boys not being okay and so worried about them, that I would have agreed to pretty much anything.  I was definitely not confident enough in the way breastfeeding works, what is “normal” for newborns, and how my boys would do health wise to stand up for my desire to breastfeed exclusively.  I understand that the doctor was likely concerned because they were small, especially Lil’ Brother, but they were already on PTN (nutrition through their IVs) and they hadn’t had a chance at all to nurse and see how they would do.  While I realize neither boy had a lot of weight to lose, I wish I would have asked more questions about why they wanted us to start supplementing so early, and why we couldn’t give breastfeeding exclusively a chance since they were 36-week babies and were only admitted for relatively minor issues.  I am not saying I would have refused to supplement, but I wish I would have fought that battle more than I did because once you start supplementing it’s hard to ever wean off of it.  You supplement because they are still hungry, which means that they aren’t nursing the full amount of time they need, which means your body doesn’t produce as much, which brings you back to needing to supplement.  It’s kind of a vicious cycle.

3.  I would never have started using a nipple shield with Lil’ Brother.  Big Brother really struggled with eating, and I have no regrets about using a nipple shield with him.  He had a hard time latching, a hard time sucking for more than a few seconds, and a hard time gaining weight as a result.  A nipple shield is great for babies with latch issues and it can be great for preemies because babies can get more milk while burning less calories. Lil’ Brother, however, latched on the first time and never looked back.  He was always ravenously hungry and would nurse happily. Further, unlike most newborns, Lil’ Brother gained weight every day for the first 5 days.  He finally managed to lose weight on Day 6, but then went back to gaining the next day. Initially, the hospital lactation consultants recommended I try a nipple shield with Lil’ Brother to save him from burning extra calories.  I half-heartedly tried, but he wasn’t having any of it. I kept nursing, and he kept gaining weight. Every time a LC would come by, they would ask if I had tried a nipple shield with Lil’ Brother. Finally, one offered to “help” me teach him to use the nipple shield, and I just gave in and said okay. She assured me that he wouldn’t have any trouble transitioning back when he was little bigger because he didn’t have a latching issue. That was the beginning of the end for Lil’ Brother being my champ eater. He adapted to the nipple shield and quickly began to refuse nursing without the shield. Between the lack of effort required by the nipple shield and using bottles multiple times a day for supplementing, Lil’ Brother has become a very inefficient eater when he’s breastfeeding. He also gets extremely frustrated when the letdown slows and he has to work more to get his dinner. Of all my mistakes, this one irritates me the most. I had a newborn baby who latched fine and was gaining weight every day since birth, and I let someone convince me to introduce something into the mix that wasn’t necessary and at least partially led to Lil’ Brother having a lot of struggles with breastfeeding and added inconvenience to the process.

Breastfeeding and parenting are on-the-job training, and if we ever have another child, I’ll be more much more confident in my ability to decide what is right for my children and more knowledgable about what I need to do to be more successful in this area. Sometimes, I wish I could go back and do it all over again, but at the end of the day, I have healthy, happy, growing baby boys, and that means we surely must be doing something right!

If you could go back and start over on breastfeeding your LO, would you do anything differently?