This is the summary for the babies’ 20th week – they were 19 weeks old.
So last week I wrote that I thought my supply might be up because my boobs were more painfully full in the morning. A few days before I posted a 4 month update on breastfeeding twins in which I pretty much said that nursing twins was a breeze and that basically any worry I had about breastfeeding them was completely baseless.
Pride comes before the fall, people.
The very next day I went to their 4 month doctor’s appointment to find out that both babies showed poor weight gain between their 2 month and 4 month appointments – presumably because my supply is low. I was completely caught off guard. There is nothing about their behavior that indicated to me they weren’t getting enough. Totally blindsided.
Here are the facts:
Between the beginning of July (the 2 month check up) and the middle of September (the 4 month check up), Sam gained 1lb 9oz and Mercy gained 1lb 7oz. Sam dropped from about the 8-9th percentile in weight to the 1st percentile and Mercy dropped from the 38th percentile to the 10th percentile.
Here are their weights on a chart:
The doctor defined this as “falling off their curve”, meaning their rate of weight gain slowed significantly from the trajectory it was on as of the last appointment. If you look at the zoomed in weights on the left it doesn’t look like that much of a drop, but when you step back and look at them on the 0-24mo charts (on the right), you can see how the weight gained dropped off from their last appointment.
Now, before you La Leche Leaguers start waving your hands and screaming “but are you using a WHO chart?!” Yes. Those are the WHO charts.
Because both babies’ weight gain decelerated, the assumption would be that they aren’t drinking enough milk because I’m not making enough milk. Those charts are literally the only indication of that, though. There are no other symptoms. They self detach and appear satisfied after nursing. Once they stop, I can squeeze my boobs and more milk comes out. They pee and poop normally. They do not seem hungry during wake times. They sleep well. Wouldn’t you think if they weren’t getting enough they would wake up to eat?
In any case, the pediatrician recommended I work on increasing my milk supply and bring them back in two weeks for a weight check. They need to gain half ounce per day. If they fail to do that, he will advise me to supplement with formula (although, I suppose I could start pumping and supplement with breast milk).
I feel torn on this issue. On the one hand, they seem like totally happy, healthy babies to me. I want to trust my body’s ability to meet their demand. I want to trust that my body is capable of producing enough milk for them. I don’t think supplementation or pumping to increase supply are necessary in order for a woman to provide adequate milk to her babies. On the other hand, the numbers are the numbers. I can’t deny that their growth decelerated.
What I decided to do was to try and get them to eat as much as possible over the next two weeks. Initially I tried adding in 3 extra nursing sessions per day, but it was extremely frustrating and stressful because Mercy would just lay there and smile at me and Sam would cry when I tried to force him on the breast. HOW CAN I GET THEM TO EAT MORE WHEN THEY DON’T WANT TO EAT?
Through trial and error I figured out that they will eat well for an extra nursing session in the morning before their first nap, so I have been doing that. A negative outcome of them nursing more in the morning is that they seem less hungry in the afternoon and evening. I am having considerable trouble getting them to eat for their last feeding of the day (7pm). Because she isn’t eating well at 7pm, Mercy has been waking earlier in the morning (around 6am). This is unfortunate.
My plan is to continue trying to get them to eat more frequently during the day and for longer periods of time. I am also taking fenugreek and drinking Mother’s Milk Tea. I have an appointment next week with a lactation consultant. I am hoping that will be enough to get them the half ounce per day weight gain they need before their next appointment. I am undecided on what I will do if it is not.
Naps remained great throughout the nursing debacle. I am really looking forward to dropping that 3rd nap. It feels really crammed in there. They need it still, but it’s inconvenient.
Night Time Sleep:
The nights were fine – no random wakings – but as I mentioned above, after working so hard to get them to sleep in until 7am (which they had consistently been doing), Mercy started waking again in the 6am hour (or sometimes even a little earlier!). Yuck. I really do think it’s a result of her not eating well at the 7pm feeding. I need to move things around in the afternoon somehow so she starts eating better at that time.
This was the schedule I was doing by the end of the week.
6:30am Wake, Nurse (1)
8:10am Nurse (2), Nap 1
10:30am Wake, nurse (3)
12:20pm Nurse (4), then down for Nap 2 at 12:30
3:30pm Wake, nurse (5)
5:00pm Nap 3
5:45pm Wake, nurse (6)
7:00pm Nurse (7), then straight to bed
Ideally I want them to go back to waking at 7am, but I’m not going to worry too much about it while this nursing situation is going on. I think next week I am going to try to nursing before the 3rd nap instead of after. This pretty much bucks Babywise‘s eat, wake, sleep routine but I’m not sure what else to do to make them eat better before bed at 7pm. My priority this week is their eating, not their sleeping.
As far as skills go:
They still can’t do much. They pretty much just lay on a blanket and watch me or watch each other. I’ve tried giving them a toy to hold but they aren’t interested at this point. Sam scoots himself around the room a bit but it’s not intentional. How can babies be so cute and so boring at the same time?