Preparing to Nurse Twins

“Ohhhhhhh, my poor, poor boobs”

I’ll never forget standing in the shower a couple of days after giving birth to my twins and feeling the stream of water hit my chest like a thousand needles.

One of my girls did NOT have a good latch and within a day or two had torn up my nipples so very badly (I didn’t get the memo on latching. I blame all of my friends for not telling me).

This doesn’t happen to everyone, but it happens to many first-timers. I even have some mommy friends who went so far as to wear a bikini top in the shower to protect their tattered nips from the force of the water. A BIKINI TOP. IN THA SHOWER. Yeeeeeauh.

The sad truth is that breastfeeding can be hard on your boobs in the beginning. Especially because you are nursing two (or more) babies. I’m not gonna lie, right after they’re born (and maybe for a while) it will seem like your poor nips never get a break! Whether you’re tandem-feeding, nursing one after the other, or nursing one and then using a breast pump for the other, your — ahem — “girls” will be busy. But if you are prepared (put on your war paint!), you’ll be much better equipped to get through it with ease.

Taking Care of Your Nipples (it’s very-freaking-important!)

Soothies: Soothies are cool, silicone pads that pamper sore (cracked, bleeding, oozing) nipples. The $10/pair price tag becomes a complete non-issue if you end up with latching difficulty and thus, a lot of pain. I suggest having one pair on hand to start; you can buy more if needed. Each pair lasts for several days.

Your nipples take so much abuse from those early days of learning how to latch properly (there’s a learning curve involved for both you and your babies). Think of the abuse your clutch took when you were learning how to drive a stick shift for the first time. Yeaa. Same thing here.

There are three things I recommend to apply directly to your nipples (recommended and blessed by my lactation consultant, Ami Burnham, LM, RN, IBCL):

1. Earth Mama Angel Baby nipple butter: this is an olive oil-based cream that is much less viscous than a lanolin-based cream. Applying thick, honey-like lanolin to sore nipples can, in and of itself, be painful. Use this instead.
2. Mother Love Nipple Cream: This literally goes on like butter. It is so soothing to your sore, cracked, bleeding nipples. Best of all, it’s completely safe for baby so you don’t have to rub it off before your babies — ouch! — latch again.
3. Neosporin: If there are open sores on your nipples, you can apply Neosporin to help them heal quickly. My lactation consultant said you can use a little bit without having to wash it off before nursing (why does it matter? Because washing your nipples hurts). If that freaks you out, consult your pediatrician. It works well, trust me!

If your nipples become damaged, use breast shells to prevent them from touching… anything, including your own bra. Ah, oooh, ouch ouch ouch. So painful.

Finally, if your babies have trouble latching or if your nipples are flat or inverted, you may benefit greatly from a nipple shield (don’t use long-term; consult a lactation consultant for more information).

For pumping, a lanolin-based nipple cream is perfect for smearing around the inside of the breast shield (see below). Like pistons in your car’s engine, your nipples also need to be lubricated while pumping or else they can become badly chafed. Think of this as Valvoline for your nipples. I don’t recommend using it directly on your nipples if they are damaged – this stuff is super viscous and may hurt just to apply it.

Breast Pads

You will also need breast pads to soak up any leaking milk (yes, you WILL leak). Not only is it embarrassing to have milk circles on your shirt, but nipples that don’t dry out properly are at risk for developing thrush, which is essentially a yeast infection of your nipples and breasts. DON’T want.

My favorite solution in the beginning is an old-fashioned disposable breast pad. There are tons of different kinds on the market, but the favorites are Medela and Lansinoh.

A couple of annoying downsides for both of these disposables are:

1. They come individually wrapped in plastic, so you have to unwrap, peel the sticky tabs off, blah blah. This requires two hands (and anything that requires two hands when you’re nursing — or doing pretty much anything with — twins is difficult!).
2. They aren’t totally smooth, so you may have that I-stuffed-my-bra-with-Kleenex look. Oh well, you’re nursing multiples. Looking smooth may not be at the top of the priority list.

I’ve tried a couple of other solutions, none of which I liked. Lilypadz (~$19) are silicone cups that fit tight against your skin. It makes your nipples look like bugs on a windshield. These are washable and reusable and are supposed to last for weeks. However, I found them to be itchy and suffocating and they did NOT last very long for me — maybe 10 days or so. Meh. They are good, however, for special occasions when you need to wear a tight-fitting or tailored shirt or dress. Fine.

You can also buy reusable nursing pads. If you don’t mind the hassle of washing them, these will save you money (and landfill space) over the long-run. *I definitely do not recommend these for beginners or anyone whose nipples might be sore or damaged, as they will stick to wounds on your nipples and just make the situation even worse. A favorite is the Bamboobies Nursing Pad set.

If you have a low supply and need to preserve as much milk as possible, try the Milkies Milk-Saver pads. You can contain the milk that you leak and reuse it. Brilliant! I know a lot of moms who use these milk-saver pads religiously.

Engorgement & Clogged Milk Ducts

When your milk first comes in, you will almost certainly experience engorgement. Engorgement doesn’t hurt, per se (unless it’s really bad), but it can be quite uncomfortable. Your breasts may feel like they’re bursting at the seams.

I also experienced engorgement when I was trying to increase my milk supply for my twins by pumping after every nursing session (FYI: the more you pump and nurse, the more milk your body will produce). It was definitely uncomfortable, but I tried to empty my breasts whenever they got too full (read: as hard as baseballs), as well as take hot showers, letting the water roll down my chest while I tried to massage out any engorgement-related knots (OUCH! Don’t let the word “massage” fool you…this is anything but!).

A few options to help with the pain of engorgement and/or a clogged milk duct or two:

• I love these ice/heating packs by Lansinoh that are circular shaped for your breast.
• You can also use cabbage leaves, which fit very nicely into your bra. Keep them in your fridge and pull one out when you need it. (note: overuse of cabbage leaves can decrease milk supply.)
• Yet another alternative is wetting and freezing a diaper (a disposable diaper). This makes for a perfect booby ice pack.
• You can also try Rachel’s Remedy Breastfeeding Relief Packs. At $19.99 for a two-pack, they are the only FDA-cleared moist heat and cooling packs (yes–they can go in microwave or freezer) made just for nursing moms. Slip these directly into your bra for instant relief for everything from mastitis, to a clogged milk duct, to engorgement to nipple pain. Melissa used these with great success when she was suffering from severe nipple pain, engorgement and clogged ducts while nursing her baby girl.

Having said all of this, you know what? You’re not going to get torn up nipples because I’m going to teach you how to properly latch. Check out our Lowdown on Latching edition.

Back to: Twins