When would you stop 4hourly feeds and swap to demand feeding???

[TaRhLi.]

O.K, so my twins are being fed differently so I need to try and establish a pattern for feeding.

So far we are on a 4 hourly feeding pattern with them with Rhys (Twin 1) being bottle feed formula and Liam (Twin B) being breastfed. Currently either one will wake around that 4 hourly mark for a feed and then we have been waking the other for feeding as well, luckily DH takes the role of feeding Rhys so we can just concentrate on one baby each.

As Rhys is on the bottle he has a very regular feeding pattern already, wake, feed and then back to sleep - obviously this is due to us being able to monitor his food intake. Liam on the other hand will wake, feed and then sometimes back to sleep although at the moment it is wake, feed, be unsettled, feed, feed some more and finally only fall asleep being held. I know that he will go through periods of cluster feeding which occur sometimes at night and sometimes during the day but I was thinking that instead of waking him every 4 hours for a feed to leave him to wake himself so that he is hungry and therefore won't take 40 mins to feed and then with any luck will be easy to settle.

DH is really concerned about not letting them go for more than 4 hours between feeds as both boys were small - not tiny - and when we were discharged from hospital it was on the proviso that they put on weight as they had be fluctuation between putting on and losing weight while in hospital and if they lost weight then they would be readmitted to have feeding tubes.

They were weighed the day after being discharged from hospital after Rhys had lost 40g and Liam 20g and in 24 hours Rhys had put on 100g and Liam 40g. We have the MCHN coming on Tuesday to weigh them again and if they have put on weight again I think I might switch to demand feeding but being aware to not let it go too long between feeds.

I know both boys are getting enough as every feed involves a very wet and very pooey nappy, so everything good in that department and I also know that Liam is getting enough breast milk as he will always possit up breast milk after every feed so I know his tummy is full.

I didn't breast feed my DD, so feeding Liam is a learning curve for me and managing Rhys's feeds are easy as we have done it before. I would really like to hear your opinions on what you think the best way to juggle feeding is.

[MantaRay]

Wow hun, you must really have your hands full! How are you coping?

I can understand that feeding the twins at the same time is less work for you. Unfortunately the problem with that approach is that breastmilk is very different to formula, and as a result the feeding needs that Liam has will be different to Rhys'. Breastmilk is designed to be easily digested, as human mums need to feed frequently to maintain supply, and because human mums and babies are usually together all the time. Formula is made from cows' milk, and cows' milk is designed to fill a baby calf up and make it sleepy for a few hours so that mum can leave the calf safely to go and graze. As Rhys is having formula, he can probably go 4 hours or so without a feed and still put on weight - although some formula fed babies do need to feed more often than that. Breastfed babies need to feed at least 8, and often 12 or more times in 24 hours to get enough milk to grow. Feeding every 4 hours or less is also not enough for most mums to maintain a good milk supply.

How are their nappies going hun? At least 5 heavily wet disposable nappies in 24 hours, and 2 or more soft or runny poos in 24 hours show that a baby is getting enough milk. Fewer nappies than this can indicate that the baby needs more food. It is common for mums to wait for babies to wake themselves to feed - and most of the time this is fine to do. However some babies, especially those that are born early, small or have jaundice, don't have the energy to wake themselves at first and need to be woken for feeds.

What is your long term plan for feeding the boys Kelly? There are some different things you could try depending on what you want to achieve. Firstly though, if you want to keep breastfeeding either one or both of the boys going forward, feeding Liam at the breast every 2 -3 hours for now might be a good idea. This will help him to get enough milk and will also help your supply. Do you think that is do-able for you at this stage? Sometimes mums also find that offering the breast again about half an hour after a feed for a top up can work well. This is when milk is at it's fattiest so this would be helpful while you are worried about Liam's weight gains.

I hope that you have good news with the next weigh-in hun.

[TaRhLi.]

Thanks MantaRay

Both boys have very wet nappies and pooey ones at every feed, so a minimum of 6 per day.

We have upped the level of formula for Rhys, at the hospital they were saying 70mls but he is already taking between 80-100mls per feed.

My aim is to keep Rhys on formula and Liam to be breastfeed as Liam has a kidney issue we need to deal with and this means lots of dr's appt's and test and possible surgery so by keeping Rhys on formula means I don't have to drag him around - especially in a Ballarat winter - when he can stay at home with DH.

DH is home for the next 4 weeks from work so he is being a huge help with feeding Rhys and also between us we can juggle DD as well, so feeding Liam more regularly at this stage is o.k for us. Hopefully though by the time he returns to work Liam's b/fing will be a bit more established as that will be when I have to juggle all 3 kids and try and feed both boys tandemly.

[onthefly]

What a lot to juggle! Sounds like the boys are going well.
Demand feeding for Liam at this point would mean more feeds, I would guess. Most newborns feed heaps and heaps. It will settle down with time though.
I hope they both do well at their weigh in.

[MantaRay]

Kelly, that sounds like a great plan. You are doing so well hun. It is definitely going to be hard work for you when your DH goes back to work, and especially with medical appointments to deal with as well, but you sound very organised and I am sure you will find a way to manage it all Have you got family or friends nearby who can help out as well?