TWIN MOMS
👩🏽‍🦳University of Utah researchers looked at 59,000 birth records from 1800-1979 and found that moms of twins tend to live longer than moms without twins.
👥Fraternal and identical twins are the most common types of twins. Other rare twin types include “half identical twins” (when the egg splits first and then each half is fertilized) and mirror image twins (Meaning they are exact reflections of one another. For example, if one has a freckle under the left eye, the other’s freckle will be under the right eye.).
🫂You can also have twins with two different fathers. Known as heteropaternal superfecundation, occasionally two eggs are released during ovulation and then the woman gets impregnated by two different men at the same time. About 1 to 2% of all fraternal twins have different dads
🖐🏿Identical twins don’t have identical fingerprints.
🍔When breastfeeding, you normally need to eat an extra 300-500 calories. It takes captures to make calories. Twin moms need to consume an extra 600-1000 calories per day!!
Twins share a unique bond that starts in utero. 👭Twins have been shown to interact with each other as early as 14 weeks gestation during ultrasounds.
🔄When breastfeeding twins it’s important to remember to switch which breast you offer each baby. Each breast has its own flow, flavor, and milk supply. Switching which one you start with helps keep breasts balanced and gives each baby equal opportunity if there is a more robust supply on one side than the other
🏈 There are many breastfeeding positions that still work for twins. Football and koala tend to be the easiest when babies are small to get a deep latch when feeding tandem. You can also practice with one baby at a time to make sure they learn how to properly latch before attempting tandem.
🛌 There are twin breastfeeding pillows that can make positioning and feeding easier.

Information on toddler nutrition seems to assume your toddler is no longer breastfeeding. Breast milk does not magically lose nutritional value after the first birthday. In fact, the US is one of the only countries to recommend stopping breastfeeding at 1. The WHO recommends continuing until 2!

Toddler breastfeeding key points:

🤱🏾Breastfeed as often as you want. There is no “recommended number of times per day” for breastfeeding. Find what works for your routine and your family. Human milk will continue to fill nutritional gaps as toddler eats more solids
👩🏻‍🍼Depending on your situation, you may be able to stop pumping while at work and still maintain a good supply when you’re home with your toddler
🚰Slowly add in more water by cup during meals
🍎Offer foods BEFORE toddler breastfeeds. Human milk still had nutritional, immunological and emotional benefits
3️⃣In general, nursing 3-4 times a day will give your toddler all of the milk nutrition they need
🥛 Research shows between 12 and 24 months toddlers average 14-19 oz of human milk per day. Between 24 and 36 months typical amounts of human milk are 10-12 oz per day
🍦Your milk IS whole milk. It has a higher fat content with more bio available nutrients than whole cow’s milk. The more human milk toddler gets, the less additional fat from whole milk or other sources is needed
🐮 Cow’s milk is a convenient source of calcium, protein, fats, vitamin D, etc. – it’s not necessary in our diets
🥩 Sources of protein: meats, eggs, fish, peas & beans, tofu and other soy products, peanut & other nut butters
🐠 Sources of fats: oils like soy, safflower flax and fish; flax seed, fish & avocado
🥬Calcium sources: dark greens: broccoli, spinach, collards, kale, turnips, bok choy, parsley, tofu & other soy products, beans: chickpeas/garbanzo beans, navy beans, pinto beans, nuts & seeds: sesame seeds, sunflower seeds, almonds, cashews, nut butters, tahini, fortified orange juice
🐄 Limit cow’s milk to 2-3 cups (16-24 ounces) per day. Too much cow’s milk increases the risk for iron-deficiency anemia

Do you some time feel like baby is constantly feeding? As long as breastfeeding is pain free, baby is making 6+ wet and consistent poops and gaining weight over time, everything is going as it should!! The more baby removes milk from the breast, the higher your supply actually is!!
Myth: If baby wants to feed more frequently than normal, and is super fussy, it means I don’t have enough milk or my milk is drying up.
Fact: babies want to be at the breast for all kinds of reasons: hunger, thirst, boredom, comfort, pain relief, for sickness/feeling unwell, when they’re grumpy, soothing, sleep, because they’re a baby. Babies are constantly going through growth spurts and requires more food. By the time they go through multiple growth spurts it’s time to teethe. By feeding more frequently they are meeting their caloric needs while helping you increase your supply while being comforted and getting some sleep. Make sure you’re getting enough rest, sleep, hydration and food to meet this increased demand.

NO STASH NEEDED
Did you know up until 2010 most people didn’t even own a breast pump? You either breastfed until you weaned or bottle fed formula. The Affordable Care Act signed in 2010 changed the game by saying insurance had to provide lactating parents a breast pump. Before that, most parents didn’t own a pump as they were quite expensive and there were only a limited amount on the market. You may have had one if your baby was in the NICU. Our mothers and grandmother certainly didn’t own a pump.

If breastfeeding is going well there is no need to have a freezer stash. Having milk in the freezer is a nice security, but if you’re usually with your baby or gone for only a short while occasionally, there is no need to have a stash. Having the right stash for your family means having enough stashed for when you’re away from your baby. If you’re gone for one feeding, you only need one feeding worth of milk. If you’re gone 2-3 feedings, you need 2-3 feedings worth of milk. If your baby is being bottle feeding while you’re away, you would pump while you’re gone to tell your body the milk is needed. That milk then becomes the stash for the next time that you’re gone. If you want to have a big stash, great!!! You can absolutely have that as an option. Just don’t feel pressured from other people’s journeys on social media to have something you may not need or use. I’ve had several moms who spent countless hours pumping and stashing only to have to donate or throw out the milk stash because they never used it and it was going to expire. I’ve also had several moms who thought you had to have a stash and were relieved to know they didn’t! Do what is best for you and your baby and not based off of anyone else. You’ve got this. Trust your body. Trust your baby.
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MAKING MILK
The uterus doesn’t tell the breasts how many babies have come out. So the breast, when things go right, is designed to readily make milk for the first 6-8 weeks to feed however many babies have come out, in the event there are twins or triplets. Milk removals in the first 3-4 days after birth, while your milk is still colostrum, help lay down the hormone receptors needed to make milk. The more the breast is stimulated in the early days, the higher the potential for the breast to make milk. In the few weeks following birth, once milk has transitioned, a high supply ensures baby has plenty of milk while going through multiple growth spurts. Supply then gradually tapers off around 11-14 weeks (“regulates”) to just what is being regularly emptied. Many people, though, don’t see this abundant milk supply in the early days. Why does this happen?

🛑 Really long labor and delivery (24+ hour birth, 4+ hours of pushing)
🛑 Lots of fluids during labor
🛑 Maternal hemorrhage/large blood loss at birth
🛑 Inefficient milk movement in the first few days after birth (inefficient baby, not pumping when baby is supplemented, tongue tie baby)
🛑 Retained placenta
🛑 Uncontrolled diabetes or thyroid disorders
🛑 Feeding by the clock instead of on demand whenever baby is cueing
🛑 Early sleep training
🛑 Supplementing baby with a bottle and not pumping at the same time (You need to feed something, either the baby or a pump to tell your body to make that milk)
🛑 Placenta encapsulation for some (in many, placenta pills boost mood and supply. For some, it can actually decrease supply)

What can you do?
✅Get help as SOON as possible. There is a few week window where supply can be increased after birth. After that window it can be very difficult to get supply up and you’ll have a higher likelihood of needing to supplement in addition to your milk.
✅Work on position and latch to optimize the time baby is at the breast.
✅Get a quality pump and have a flange fitting
✅Have tongue and/or lip ties addressed
✅ Pump when baby is being bottle fed, even in the MOTN
✅Stay hydrated and if there was a blood loss, eating iron rich foods and quality nutrition can help as your blood supply rebounds.

PUMP TIPS
⚖️Pumping is never an accurate measure you your supply
⏰ Pumping is time consuming. It still involves set up and clean up
📏Pump flanges that are sent with the pump are not one size fits all. They are not even one size fits most. The majority of people who pump will need to buy a smaller flange
The soft parts (membranes, tubes, duckbills) wear out with time and need replaced occasionally. The more you pump, the more often these will need to be replaced
🍼If your baby is being fed, you need to feed something: feed the baby or feed the pump. If you want to make the milk your baby needs, you need to be pumping as often or even more often to maintain your supply
🌛Pumping overnight can be crucial for maintaining supply
☄️Test for high lipase early into your pumping journey
🌪Pumping on the highest vacuum is never a good idea. If you have to crank the suction up, either you have the wrong size flange or a bad pump
🤱🏾Pumping while also breastfeeding is never a true indication of milk supply
💣Not all pumps are good pumps. Some are really crappy and it’s the pump that will sabotage your supply, not your body
🚰Some can breastfeed fine and never trigger let downs well to a pump
😵‍💫Pumping shouldn’t be painful
🤲🏼Alternate the stimulation/massage and expression modes often while pumping to trigger more let downs
👐🏾Massaging and shaking your breasts before and using hands on compressions while pumping can help you empty more milk

While breastfeeding is optimal, there are times when supplementing with formula may be given by choice or necessity. Formula feeding your breast fed baby is a GOOD choice when needed and you should feel supported in how you are feeding your baby, especially if breastfeeding is still the end goal. If you are offering your baby formula, safe preparation, handling, and storage are important to know about.

• Wash first: Use hot, soapy water to clean all bottle parts (and your hands!!!) before mixing formula
• Follow the directions: Formula makers have different mixing guidelines, so check the instructions if and when you change formulas. Most manufacturers use the same recipe: 1 level scoop of powder for every 2 fluid oz of water. ALWAYS add the water first to the bottle. If you add the powder first and then try to fill with water to the ounce line, you’ll be using less water than directed as the powder displaces that space.
• Measure accurately: Too much powder might cause an upset tummy for baby. DO NOT ADD EXTRA SCOOPS to increase calorie count. You’ll also be increasing every nutrient in the formula which can cause baby to get too much protein or other nutrients. It also decreases the amount of water baby is getting which can lead to hydration. Calorie fortifying should only be done under the direction of a pediatrician or pediatric nutritionist. Adding more water than directed can make baby sick
• Check for clumps: Look at the formula after mixing to make sure there are no clumps. They can get stuck in the bottle nipple. Use a fork to separate clumps and shake again
• Time it: Mixed formula stays good for 2 hours at room temperature. You can mix up one bottle at a time, or mix a full day’s worth in a pitcher and refrigerate it for up to 24 hours, pouring individual bottles to feed from one large batch
• The right temperature is anywhere from cool to lukewarm. If your water is safe, it’s OK to mix powder with room temperature water right from your tap. NEVER put a bottle of formula or breast milk in the microwave. This can create hot spots that would burn baby’s mouth

To warm formula:
🥵Use boiled or hot water while mixing the formula, no additional heating needed
🚿 Run the bottle under very warm or hot water for a few minutes
🔥Fill a pan with hot water. Remove it from the heat. Place the bottle in the pan for a few minutes
🍼Use a bottle warmer
💧After warming the bottle, shake it vigorously to make sure there are no hot spots in the formula. Test it by squirting a drop on the inside of your wrist. If it’s hotter than lukewarm, let it cool down before feeding it

BREAST CHANGES
When you’re pregnant, breast tissue for making milk increases, accounting for the size increase you experience during that time. On day 3-4 after birth when your milk transitions from colostrum to mature milk, your breasts engorge. This means extra blood (hello veins) and fluid fill the breast to support making milk. This additional blood and fluid are what help make you aware of that full breast feeling before each feeding. Your uterus doesn’t tell your breasts how many babies were born, so the body is prepared to make milk for 1, 2, or even 3 babies and often initially makes more milk than is needed.
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Around 6-8 weeks, your hormones shift and the extra blood and fluid in your breasts go away (not your milk supply decreasing). You may no longer feel that full/empty sensation between feeds, but still be able to see lots of milk, because your body knows baby is on a full milk diet and going through multiple back to back growth spurts. You may occasionally engorge if you go too long between feedings or if you skip a pump session.
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Between 11-14 weeks, your body has finally figured out how many babies it is feeding based on how often the breast is emptied. Your breasts will go back to their prepregnancy size while still making just enough milk for baby. Congratulations on your mom boobs. They no longer feel full/empty, making them feel like pancakes and leaking often slows or stops. You have not lost your milk supply, your body is more efficient at making milk and will consistently make what is routinely emptied. You are still maintaining a full supply as long as you’re continuing to feed on demand or (routinely pump).
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Don’t be alarmed when these changes happen. This is the normal process that every body will go through

TONGUE TIE
“It’s only a minor tie, they’ll grow out of it”, “They’re gaining weight fine, try a nipple cream or shield”, “At least they’re still getting your milk from a bottle”, “Breastfeeding just isn’t for everyone” “Baby is gaining weight just fine, you can deal with the pain”.

Parents tell me they hear lines like this from their health care providers. That just isn’t right and it makes me so upset. We have to remember that breast/chestfeeding is the biological norm and if a baby is struggling to latch there is always a reason. The number one reason I see for nipple pain and damage is tongue tie (after we’ve worked on position and latch).

While nipple tenderness is normal for the first week after birth, nipple pain and damage should NEVER be considered “normal” or part of routine feeding. Weight gain is only a piece of the breast feeding puzzle, and while it’s an important one, it only focuses on half of the breast/chestfeeding dyad. Offering your milk is important, but for some families the container it comes in can be VERY important. Unfortunately nipple pain and damage have been normalized by society and even by some health care providers. If a health care provider tells you there is no tongue tie and not to worry about nipple pain and damage because baby is gaining weight well, they should also be referring you out to a lactation specialist (IBCLC) to get to the root of why you’re having that pain and damage. Keep looking for your answers.