The term breastfeeding carries weight. If you’re a new Mom, like I was September 2020, you begin your journey with expectations and images of what it should look and feel like.
The reality is often not even close to what you expected.
Most of us think we are going to give birth and it is going to be a hard, but beautiful and life-changing experience. Then in those first magical 24 hours we will have skin-to-skin with our newborns, where they instantly learn to latch and begin feeding. Admittedly, I think I was naïve enough to think that with twins it was going to be a piece of cake. One at one breast and one at another, cradled in my arms.
Again, reality is often a tougher gut-check.
My body had other plans. Preeclampsia reared its ugly head during delivery and for my safety, I was put on magnesium sulfate. I think it saved my life. However, one of the side-effects is a delay in breastmilk coming in. That, coupled with another side effect of intense brain fog that I can only describe as a dream-like state. I couldn’t seem to communicate with my limbs accurately, or verbally communicate at a speed resembling my normal fast-paced east coast ramble. This resulted in my inability to hold a baby without direct assistance, let alone two.
I felt every emotion. Guilt. Sadness. Pain. Loss. Especially when I was told after 24 hours that I would need to supplement. Suddenly I was in a race between being able to get my milk to come in fast enough for two babies and a hospital discharge.
Multiples present a lot of challenges.
Thankfully for Chantal Burke, her supply wasn’t her biggest challenge. It was her time.
Rhet and Remy are a little over one-month-old, and like most babies that age, are getting fed every three hours. When you’re a parent of twins, the schedule is your bible – and both babies better be on the same eating and sleeping time frame. For Burke, couple that with being a mom to two other kiddos, Kruz and Zoey, and I don’t know how she is able to get even a second of a nap in.
At the start, Burke tried putting the twins to breast, just like she had done with her other children. “Rhet never really latched very good. He would get really frustrated and so we always bottle feed after I nursed anyway.”
Remy was a two-week NICU baby at Meriter and has made more progress than her brother directly at the breast. “The other night, I nursed her just to see how she would do, and she did wonderful,” Burke continues, “but right now, I’m just pumping into bottles because it’s easier, and we can get back to bed and get on with our day, rather than it being an hour-and –a-half process.”
Feeding two babies takes time, even with a partner involved. Solo? It is an amazing balancing act – one that Burke handles like a pro. Still, under the surface lurks that intense “mom guilt” (and I can certainly relate).
“At first it was really hard [to exclusively pump] because with my other two children, I nursed. I had that one-on-one connection with them. I had a really hard time at first when Rhet wasn’t latching, but now that I’m a month in, I realized that it is a lot easier with two to just pump.”
I’m not sure where the shame comes from. We all get asked often, “are you breastfeeding?” Well, yes and no, right? Baby isn’t latching at breast, but they are getting breastmilk.
“It’s a little bit of semantics and alphabet soup.” says Sharon Marshall, Family Health Education Specialist-Breastfeeding at UnityPoint Health – Meriter. “What [breastfeeding] means is most importantly what it means to you, as the lactating parent.”
Marshall goes on to describe that “breastfeeding includes a range from exclusive breastfeeding to pumping and bottle feeding.” Like me, many parents struggle to make enough to feed their children and in order for them to thrive, also add in formula to make up the difference in milk intake.
What’s fascinating about lactation is that the emotional response from it is tied to a lactating parent’s hormonal output. The surge of oxytocin is what allows for let down, for the milk to flow. For a newborn, studies have shown that cortisol levels, an indicator of stress, spike when they are removed from the breast. It’s clear that breastfeeding offers emotional benefits for both parent and baby.
If you’re a parent that has to pump, it’s recommended to do it while you can look at your babies, or look at photos or video of them, to keep that emotional connection and signal let down. Burke often tries to pump while bottle feeding, even though it poses its own challenges.
Burke did initially feel concerned that her twins weren’t going to get the same emotional support that one gets while exclusively breastfeeding, but then realized that they will still get emotional support in other ways, and that’s okay.
Marshall recommends still making time for skin-to-skin if you need to exclusively pump.
Overall, Burke says, “It was hard at first, but you really come to the realization that with two it’s just going to be different anyway.” And at the end of the day, they are well-fed and growing. That’s what matters.
For Suellen Hunt, her second child, Lily, had a much easier time breastfeeding than Owen, her first.
"This time around was so much easier,” Hunt proclaimed. Her daughter, Lily, was styling an adorable pink bow and a white onesie as Hunt stepped outside to breastfeed her.
Not to be outdone, her three-year-old son, Owen made sure I could witness him playing with his Dad, George, on his bicycle.
“I didn’t have any pain.” shared Hunt, who was grateful for a smooth breastfeeding journey after having mastitis with Owen.
When she had Owen, Hunt lived in California and as a first-time mom worried a great deal about the first 24 hours when he refused to latch. By the time she got home from the hospital, Suellen had developed mastitis, which can cause pain when breastfeeding. This common condition is an inflammation of the breast that can happen when a blocked duct doesn’t clear, or when the buildup of milk causes swelling and inflammation. Breastfeeding should not be painful, but luckily, mastitis can be easily treated, and breastfeeding experience can quickly improve.
Sharon Marshall, Family Health Education Specialist-Breastfeeding at UnityPoint Health – Meriter says that treating swelling and inflammation related to engorgement and mastitis is important. For plugged ducts, she recommends warmth and massage, “sometimes vibration, like the back of an electric toothbrush if you place that against the side of a plugged duct. The goal is to get the milk to move because milk stasis can be one of the things that can lead to breast infection.”
Luckily, Hunt’s second child, Lily, latched right away when her milk came in quickly.
“It was so amazing.”
I love hearing about experiences like Hunt’s. It truly is amazing when latching happens easily, and there is a sense of fulfillment of being able to provide for your child in that way. After a month and a half of strictly bottle feeding my own twins a mix of formula and breastmilk, I decided to try breastfeeding again. One of them, Jack, latched easily. In my experience, that was a momentous success.
Marshall talks a lot about parents defining their own expectations and ideas of success, aside from what glossy images on social media might portray. “As lactation consultants in the hospital, and family health educators, we are here to help parents meet their goals. If there are struggles to meet that goal, we work to bring you close to it and make you feel positive about where you are at with those goals.”
Hunt feeds Lily on demand, often nursing her to sleep. At four months, she has seen her double her birth weight already.
“I believe breastmilk is the most nutritious food I can feed my babies, and that helps their immune system fight viruses and bacteria, allowing them to grow healthy and strong.” says Hunt.
“Physiologically, there are so many benefits to the actual human milk. The early milk is high in glucose to help prevent hypoglycemia, it’s very high in protein, calories, fat. Milk adapts and changes with the size and age of the infant to give them what they nutritionally need,” says Marshall.
Another big bonus? Antibodies. It is why I kept trying to breastfeed my twins, and why I felt breastfeeding one, even if infrequently, was still worth it.
Marshall mentions, “We now know that if a child goes to daycare and is exposed to something there and then comes back home and breastfeeds – their saliva gets picked up by the lactating parent’s body, and the parent starts making antibodies. Transferring those through milk without any direct exposure.”
"I feel so blessed for being able to breastfeed, and love that my body is working as it was designed to. I never really stressed too much about my supply because stress can also hurt it. I just did my research, ate well, drank lots of water, trusted God, and my body. And it works.” shared Hunt.
Joan Lin’s adorable second son, Will, is now 7 months old. When I met him over a month ago, he was highly distracted by my presence and the camera.
Lin’s experience with creating enough frozen supply for work is something most parent’s can relate to.At that time, Lin was worried she didn’t have enough breastmilk stored from pumping to send him off to childcare while she was at work. So, she tried formula for the first time. It didn’t go so well for Will; his stomach didn’t seem to settle. She plans to take him to an allergy clinic later this month to learn more, but is fully back on breastmilk, with a “marginal freezer supply.”
At Meriter, there is a “Breastfeeding Basics and Returning to Work” class that has a large focus on building up supply for return to work. It includes valuable advice on when to start pumping, how and when to introduce bottle feeding and how much supply to have fresh and frozen.
Lin and Will have fallen into an easy routine. “As he’s gotten older [breastfeeding] is one way we connect that is the same, in the midst of all of his developmental and physical growth!”
What really stands out about her time breastfeeding Will is that “multiple times a day we can reconnect without having to be very intentional or with much effort.” For most parents, once you get past the initial newborn stage, there is something really comforting about the ease with which breastfeeding takes place.
She also wants mom’s to be prepared that breastfeeding is often harder than expected and that is completely normal. “Yes, breastfeeding is natural. It’s an instinct, but it’s still work.”
Her biggest advice is “talking with people who have similar circumstances, or reaching out and finding other people to normalize it for you. I think having people as sounding boards to just listen, and not necessarily offer direction.”
What Lin had to say really resonated with me. I sought out so much advice from friends that had recently had babies, and found myself on Facebook groups with other parents with multiples. The most helpful part of that was having a friend, who went through the process of feeding a baby, really listen and offer support, rather than clear cut advice. Sometimes, you really just need to be heard.
Sharon Marshall, Family Health Education Specialist-Breastfeeding at UnityPoint Health – Meriter sums it up what matters well, “What matters most at the end of the day, is that every nurse and lactation consultant is here to help parents meet their goals. Any drop of human milk is a victory, any moment that a lactating parent spends enjoying breastfeeding is a victory, and any baby that gains weight with the help of mother’s own milk is a victory.”
“I think it’s pretty amazing to look at a person who’s growing rapidly and think all the nutrients that they need comes from you,” shared Ali Muldrow. Breastfeeding has “been an easy thing to love doing.”
Less than two months old, Muldrow’s daughter Frida is nursing on demand. She breastfed her two other children as well.
“I wish the whole framework that we thought about breastfeeding changed. And I think seeing breastfeeding as this divine right, to take care of your baby and seeing yourself and your body as something that you are in charge of-I think is something Black women are denied aggressively. This conversation about whether or not black women are choosing to breastfeed is the wrong conversation. This is not a choice.,” shared Muldrow.
For Muldrow, who is well-known in the Madison community as the Co-Executive Director at GSAFE, an organization working to create just schools for LBGTQ+ youth, reclaiming health is about reclaiming liberation.
“It’s something we can do for ourselves and for future generations,” shares Muldrow. “In breastfeeding, you are taking something back for the next generation of people that we were robbed of. We’re robbed of time with our kids, robbed of affection and our children are denied the right to be children right from the beginning.”
A 2018 study on social, cultural and historical influences on Black breastfeeding found “there are potential contributions of generational, cultural and historical factors.” The study specifically mentions slavery and “wet-nursing” as detractors from breastfeeding.
“The average slave gave birth multiple times during adolescence, and then was forced into forced labor about two weeks later. So, this idea that there's space for Black women to rest and heal and bond with their baby, that's been completely devalued throughout the history of our society. We actually have never recovered from that, “said Muldrow. “You have to have a conscious conversation about what does it look like to recover and reclaim. It means, yeah, breastfeeding, but it also means having the financial reality and the housing and the employment support and the space and the equipment to pump and the different things that you need to support you in breastfeeding.”
While Meriter offers many avenues of support, like breastfeeding classes and lactation consultants, there is more that we need to do, which is why hearing experiences like Ali Muldrow’s are so valuable. Learning and change occurs through listening to the experiences of Black women and hearing from them what kinds of programs of support would be the most beneficial to them.
One such avenue for providing valuable feedback is through the Patient and Family Advisory Committee (PFAC), comprised of community members and employees, led by the Patient Experience Partners. Any community member is welcome to apply to join. Patients are welcome to share experiences with our Patient Representatives at 608-417-6462.
UnityPoint Health – Meriter is also actively involved in the Saving Our Babies initiative. To learn more about the program, visit Saving Our Babies - Foundation for Black Women's Wellness (ffbww.org)
“Positioning Black women to have healthy pregnancies and to have healthy babies and to feel confident in caring for their kids - that’s about reorienting our society to Black women as human beings.” says Muldrow as she shifts Frida to her other breast, who has been feeding consistently and with gusto. “She believes in it,” Muldrow laughs, “she feels completely entitled to growing.”