Dear Andi… Breastfeeding Q & A with Andrea Mansor, LC {Part 3}

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It’s National Breastfeeding Month, and we are continuing our series with Board Certified Lactation Consultant (and Scottsdale mom/grandma!) Andrea MansorIf you missed our first two Q & A posts, you can find them here and here. This time around Andrea (aka “Dear Andi”) is talking to two moms – both named Jamie! – about over-abundant milk supply and breastfeeding twins.

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Dear Andi,

I have a large milk supply (the rivers never run dry!) and my 3-week-old daughter spits up a lot after every feeding (she is exclusively breastfed). Are these correlated and is there anything I can do? Does pumping and bottle feeding make a difference?

Jamie

A baby girl – what a blessing, Jamie. Often mothers yearn for your problem of oversupply without realizing it is, in fact, a problem for many moms and babies. Spitting up, pulling off the breast to take a breath during a forceful letdown are typical with a large milk supply.

There are a couple of things you can try. Positioning baby in a modified football hold where she is more upright facing the breast may help her to handle the flow. Or you can latch her on, then lay back in a lounger chair (termed the Australian crawl) so she is “feeding uphill” against gravity. That can slow your flow. As you feel your initial letdown which is often the strongest, you can de-latch your daughter from the breast and allow the milk to spray into a washcloth. Then re-latch her.

I would encourage you to try to complete the feeding on the first breast before switching to the other side. Research indicates that babies have better weight gain with one sided feedings. If she completes the feeding on the first and still indicates she wants more then you can put her on the other. Your body should begin to self regulate and adjust to this way of breastfeeding. However, if your opposite breast feels firm and tender, you can try to express some milk from that side to make yourself more comfortable.

Emptying the breast to comfort is key: pumping and breastfeeding, when done to an extreme (ie. pumping after every feeding) can lead to more milk. In your case, this could become problematic and contribute to plugged ducts and even mastitis. Balance is the key. Pumping and bottle feeding is an option some mothers choose but if you can hang in there to allow your body to self regulate you may find it more convenient and enjoyable to just breastfeed vs needing to rely on having the pump always available.

Dear Andi,

When breastfeeding twins, do you start with tandem feeds or get each baby used to the latch on their own and then start tandem feeding once they are able to latch correctly?

Jamie

Congratulations Jamie on expecting twins. You have many adventures ahead of you and breastfeeding is just one of them. In answer to your question, I would say there is not a definite “do it this way” with breastfeeding twins. My best advice is flexibility and early initiation of breastfeeding to build a supply for two.

Because twins often deliver early, it is not predictable how ready they may be to breastfeed. Babies born between 34 to 37 weeks are “late preterm” and many twins fall into this gestational age group. Late preterm babies tend to act their age. A baby born at 34 weeks does not show the same readiness for feeding as a baby born at 39 to 40 weeks. Also, both twins do not always feed the same with regards to latch ability and alertness.

A first time mom is trying to learn this new skill along with her baby and it takes practice and patience. In the case of twins, both babies need to learn and one often outpaces the other. When I help mothers of twins I typically encourage mother to work with one baby at a time until both babies are latching well. If only one breastfeeds, then I encourage mom to pump for the other so her milk supply is stimulated for two.

As each baby demonstrates good latch skills mom can begin attempting tandem feeds. That is beneficial to milk supply and saves time. The first couple of weeks is an important time for building milk supply and frequency of breast stimulation has enormous impact on supply. Mothers of twins will spend a lot of time feeding and/or pumping so having additional help at home for other baby tasks is important so mom can focus on rest, recovery, and feedings. Best of luck to you and your new family.

Do you have breastfeeding questions for Andrea (Andi)? Leave your questions in the comments below. We can’t promise that every one will get answered, but we’ll add them to our list for future Dear Andi posts.

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Andrea Mansor has been assisting mothers and babies with breastfeeding for 15 years, first as an RN working in Obstetrics then as a Board Certified Lactation Consultant since the year 2000. She and her husband George have lived in the Valley for more than 30 years and raised their family in the same Scottsdale home since 1985. The mother of four grown children and grandmother of two (with two more on the way!) Andrea finds immense satisfaction in helping young mothers. She has facilitated a new mom/baby support group for the past 8 years. Andrea encourages mothers to ‘get to know their babies’ and ‘be in the moment’ as they navigate the challenges of motherhood and breastfeeding.

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