Kasia Jedrzejewska, London, UK

Alex was three pounds and nine ounces (1.8kg) when he was born. That’s about half of an average newborn’s weight. His twin brother Nathan was six pounds and eight ounces (3.1kg). Although they had separate placentas and separate amniotic sacs so that one should not have been taking from the other, from the very beginning, Alex was much smaller than his twin. They were born in the 38th week by elective cesarean; but Alex looked like a premature baby — he was so skinny and bony. He was very quiet and weak. He didn’t want to breastfeed and his temperature was unstable. They took him away from me to the special care unit an hour after birth. He wasn’t put in an incubator but he needed a heater. I cried every time I visited him and saw the tube in his little nose and needles in his tiny hand: his hand was the size of an adult’s thumb. After five days, I was discharged from the hospital with Nathan. Alex remained in the special care unit.

After two days they offered us the opportunity to “room in.” They gave us something like a hotel room in the special care unit, where all the nurses were just next door. Nathan, Alex, my husband, and I could all stay there and we tried to teach Alex how to breastfeed. And we did it! Next morning they weighed him and he had gained weight. I could finally take him home. Everything was going well but suddenly, after two weeks, I got a very bad finger infection. When you have twin newborns at home you feel like you need another pair of hands. It’s a really big problem when one of your hands is taken away from you! I could barely do anything with my right hand because of this infection. I couldn’t position my babies properly when breastfeeding and started having problems with sore and cracked nipples. My nipples were really bad; they were sore for weeks. It was so painful to breastfeed. Nursing twins I didn’t have a chance to let my nipples heal. I wanted so much to breastfeed, at least for six months, but I was really struggling. I wanted to be one of those mothers who enjoy breastfeeding but I was so far from that. All I was experiencing was pain and stress. My nipples were bleeding, my babies were crying, and I was crying. I was so stressed whenever it was time to breastfeed.

Alex didn’t want to eat and he cried a lot. He was still so skinny and was gaining weight very slowly. I started seeking help. I called a midwife, a health visitor*, and La Leche League. A visiting health practitioner advised me to take two days off from breastfeeding to give my nipples some rest and then focus on positioning again. I had far greater problems with Alex than with Nathan, probably because Nathan and I had had breastfeeding help in hospital and he had been feeding from the breast from the very first day. Alex, however, didn’t have that help and started taking the breast only after five days. He was very weak and his mouth was so tiny that he could only catch a nipple. Helen, a La Leche League Leader, suggested focusing on Alex’s needs rather than trying to put him in a three-to-four-hourly routine of feeding, which is what I was advised to do in the hospital. She helped me with positioning. Now I know that I should have listened to her but, at that time, I thought I wouldn’t get anything done if I fed him whenever he wanted feeding. I was getting hardly anything done except breastfeeding anyway, trying to stick to the routine with both babies. So I took a break from breastfeeding.

After two days Nathan was reluctant to take the breast but eventually he did start to take it again. Alex rejected the breast completely. He screamed even if I put him near it. He preferred feeding from the bottle. They were about nine weeks old at that time. I kept trying but nothing worked. I felt really bad about it, thinking that I hadn’t provided the same start for them both. I felt that both of my babies should be breastfed. I had this weird thought in my mind that breastfed babies are happier and more successful in their future lives. I felt like a bad mother, like I hadn’t tried hard enough to teach Alex to breastfeed. I was expressing my milk for him but I felt it wasn’t as good as breastfeeding. When they were about two and a half months old I had a painful breast infection, which I didn’t recognize as such at first and didn’t know how to take care of. I went to my doctor and he said it was just a sore nipple. He gave the wrong diagnosis although the symptoms were very clear: fever, stabbing pain inside, pus and the whole breast was very painful. He advised me to quit breastfeeding if it caused me so much trouble. Luckily, I saw a visiting health practitioner the same day and she told me to go to see the doctor again because in her opinion it was definitely an infection. Next day I went to another doctor. I had to take antibiotics. I didn’t stop breastfeeding.

When I was exclusively breastfeeding, the whole thing would take from 40 to 90 minutes. When I was breastfeeding Nathan, bottle feeding Alex and expressing my milk, the whole procedure took over two hours each time. I was really exhausted since I was getting only four or five hours of interrupted sleep each night. My milk supply started to decrease. I noticed that the infected breast was producing much less milk than the other (I had mastitis). I had to formula feed once or twice a day. Breastfeeding, bottle feeding, expressing milk, preparing formula milk and sterilizing — that was a lot of work. But one good thing came out of it: Alex started gaining weight. I started feeding him more often and he was taking more from the bottle too. He often used to cry after his breastfeed and needed to be comforted a lot but stopped crying after his bottle. I felt that he finally was getting enough. Most probably it was easier for him to suck milk from the bottle than from my breast. After only a few weeks of bottle feeding he seemed to become more settled, calm and happy. He was gaining weight and started looking chubby. I got another breast infection; but this time I recognized quickly what it was. I called Helen of LLL and got a few very useful tips how to treat it. She really helped me and saved me from suffering a lot of pain. I took antibiotics again. A few members of my family and my friends suggested that perhaps I should stop breastfeeding because it was tiring me out. But I didn’t.

Finally I could tell what the pleasure of breastfeeding was like. It wasn’t painful any more. My only worry was that Alex was not benefiting as much as Nathan. Somewhere deep in my heart I still had a hope that maybe he would come back to the breast. However, it didn’t seem very likely. I’d heard and read that once a bottle has been introduced your baby won’t want to take the breast again. I shouldn’t be saying it but I felt closer to Nathan than Alex and I also felt bad and guilty about that. Maybe it was because I had spent the first week after the birth with only Nathan; maybe because Alex had been such a fussy baby at the beginning and it had stressed me out so much. Maybe it was because he caused me so much pain when breastfeeding, or maybe because he had stopped breastfeeding and I had spent more time with Nathan when breastfeeding him while someone else was bottle feeding Alex. I was trying to put Alex to my breast from time to time just to check whether maybe he had changed his mind. Most of the time he screamed even when I just put him near my breast. Sometimes he sucked a few times and that was all. Suddenly something changed. I put him on my breast and he started feeding for a few minutes and again the next time. And again and again. He was breastfeeding once again and he was sleeping longer: like he had after taking a bottle, he was calm and happy. I was the happiest mother in the world! After a two-month strike he had changed his mind. I was so proud of myself that I had managed to put him back to the breast and I was so proud of Alex. Maybe he finally felt strong enough to suck from the breast or maybe he didn’t feel I was forcing him any more. I relaxed and he relaxed and he did it. Breastfeeding helped me to bond with him. Now Alex prefers breast to bottle. He loves cuddling and falling asleep at my breast. The greatest thing is that now I feel equally close to both of my sons. I feel that I give them my love, my attention and my milk equally. Now Alex and Nathan are nine months old, I am still breastfeeding them and I love it. I’m planning to continue breastfeeding till they are a year old or maybe even longer.

*A health visitor in the UK is a qualified nurse or midwife who has gained additional training and qualifications to work in the community supporting families while babies are still young. They are trained and employed by the UK’s National Health Service (NHS).

Originally published in New Beginnings,Vol. 25 No. 6, 2008-09

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