We are thrilled that Raechel Hackney, RN, IBCLC, from Lactation Care, Inc in Newton, MA, agreed to address Twin Life Magazine’s questions on the topic of breastfeeding.
Lactation Care has been in business since 1990, and offers prenatal classes for expectant families, sales and rentals at two locations in MA, private consultations with an International Board Certified Lactation Consultant, telephone support and a corporate lactation program that offers assistance and equipment to breastfeeding mothers returning to employment outside the home.
TL: Why is breastfeeding the best feeding method of any child, twins and multiples included?
Years ago, I saw a bumper sticker that read “I immunize my child everyday – I breastfeed.” This statement cleverly summarizes the fact that breastmilk is more than just the right mix of calories, fat, protein and carbohydrates.
Breastfeeding offers countless mechanisms to protect babies from infection and diseases. In addition to various specific antibodies to fight infection, there are over one hundred non-specific factors in breastmilk which aid in the fight against bacteria, viruses, fungus and other pathogens which may cause diarrhea, ear infections, urinary tract infections, allergic reactions and other illnesses. Amongst the many unique components, only found in breastmilk, are live cells, called phagocytes. These cells are like little pac-men who can travel around in the baby’s digestive tract attacking and engulfing harmful bacteria. Breastfeeding also confers long term health benefits by reducing rates of other illnesses such as Type 1 diabetes, asthma and allergies and certain childhood cancers.
Breastfeeding, by its very nature, also ensures frequent, close, physical contact between a mother and baby. Numerous studies have shown that this physical touch and nurturing is as important to an infant’s survival as other basic needs.
For mothers delivering twins or higher multiples, there is an increased risk of premature delivery and longer hospital stays. For those more vulnerable babies born early, the benefits of breastmilk and breastfeeding to protect against infection are even greater.
TL: What should moms expect?
Breastfeeding is a learned art, and as humans we are meant to learn and benefit from the experience and guidance of others. If an expectant mother has had little experience being around other breastfeeding mothers, finding a breastfeeding support group, taking a prenatal class and talking to other mothers who have successfully breastfed is invaluable.
A new mother may encounter challenges with getting her baby to latch properly and comfortably. Some babies may be particularly sleepy during the first few days, especially if they were born early, if there was a prolonged and difficult labor, or if the baby has newborn jaundice due to elevated bilirubin levels (not uncommon if babies are born early or have difficulty feeding in the first few days).
Some soreness with breastfeeding in the first few days or sometimes weeks, is not uncommon, but pain should never be considered “normal.” Getting help if the discomfort continues beyond the first few days is essential. No mother should find breastfeeding painful.
Many mothers who breastfeed may worry whether their babies are getting enough milk. With frequent, unrestricted breastfeeding in the beginning, most mothers will be able to establish an abundant milk supply. Though mothers of twins may have more of a challenge in producing enough milk, the increased stimulation provided by having two nursing babies will signal the body to make more milk. Keeping track of the number of wet and soiled diapers, and following weight gain will help determine whether babies are getting enough to eat.
TL: What kind of merchandise will moms need?
Though very few items are absolutely essential, there are several things that will help make breastfeeding more comfortable, efficient and successful.
Many mothers today are interested in having a breast pump available, whether it is for occasional use or for the mother who will be returning to work or school while her child is still breastfeeding. There is a dizzying range of pumps available and one of the services we provide at Lactation Care is to help a mother choose the right pump for her needs, whether it be a simple manual pump, a purchased electric double pump or the most efficient hospital-grade electric pump. For the mother whose baby is born very early and is unable to breastfeed initially, it is essential to initiate pumping with the most efficient pump as early following delivery as possible.
Nursing mothers need well-fitting bras and can be resized in the 8th or 9th month of pregnancy or following delivery. They should be fit with a comfortable, supportive nursing bra, if possible by an experienced and certified bra fitter. As we say at Lactation Care, there is never a time in a woman’s life that she needs a more comfortable bra than when she is nursing.
Various nursing pillows are available on the market, however a mother should choose a very firm pillow, ideally with a strap to keep the pillow hugged in close to her. There are a number of twin nursing pillows on the market, which will assist a mother nursing both babies simultaneously.
We recommend expectant mothers purchase two or three basic books on breastfeeding. We recommend: The Preemie Parents’ Companion: The Essential Guide to Caring for Your Premature Baby in the Hospital, at Home, and Through the First Years, by Susan L. Madden, M.S.; Mothering Multiples: Breastfeeding & Caring for Twins and More, by Karen Kerkhoff Gromada; Nursing Mother’s Companion, by Kathleen Huggins and The Baby Book: Everything you need to Know about your Baby, by Martha Sears.
TL: How long should a mother breastfeed her child?
The American Academy of Pediatrics recommends breastfeeding for a minimum of one year, longer if both mother and baby so desire. The World Health Organization recommends a minimum of two years. How long a mother breastfeeds is a personal and family decision. Breastfeeding continues to provide a wonderful source of nutrition well beyond the first year. Some of the components of breastmilk change subtly over time to match the needs of the older baby. Breastmilk continues to provide protection from infection well into the toddler years and will also remain a means of comfort and closeness between a mother and her child. Nursing children for 3 or 4 years and beyond is unusual in the United States, but is not uncommon in many parts of the world.
TL: What would be your main advice for mothers choosing to breastfeed?
Take a prenatal breastfeeding class if this is your first experience with nursing, or if you have had difficulty with breastfeeding in the past. We emphasize the importance of bringing your partner or other support person. Gather your resources, purchase a few good books on breastfeeding, attend a local support group and get references for International Board Certified Lactation Consultants (IBCLC) in our area who provide private consultations.
Our general advice to nursing mothers includes eating three meals and three snacks per day, drink to thirst, rest between feeds and limit visitors unless they are helpful.
Know that each mother can define her own breastfeeding success, and as we always say, the top priority is to enjoy your baby.