Twin pregnancies are high risk pregnancies. According to the American Academy of Obstetrics and Gynecology:
The most common complication of pregnancies with multiples is preterm birth. More than one half of all twins are born preterm. Higher-order multiples are almost always born preterm. Babies born before 37 weeks of pregnancy are considered preterm. Breastfeeding preterm multiples can be challenging but it does not mean it won't be successful.
My girls were no different. They were born by emergency c-section at 32 weeks, about two months early. They were in the hospital about a month and during that time while they were being cared for by hospital staff, making milk was my primary job.
My girls were not feeding for the first few days. Nothing eaten by mouth or by feeding tube was common until a few years ago. I knew the more I pumped the more I would make milk but in reality I was frustrated by the small amounts in the first few days. At that time I was not aware of the importance of hand expression. I was just pumping and getting droplets. When I left the hospital I was just able to fill small syringes with colostrum. At first I was getting frustrated with pumping for 30-40 minutes at a time with almost nothing to show for it. I was in a daze. I would just pump and pump and pump. After a few depressing days I started a new plan. I discussed my concerns with the lactation staff and neonatologist. My new goal was to pump 10-12 times a day and not more than 15-20 minutes each time. I was surprised, I started making so much more milk. At that time donor human milk was not an option like it is today. Eventually I had to make a hard decision. I did not have enough breastmilk for both my babies. I gave the sicker twin at the time more breastmilk than her sister. Eventually my supply increased and they were able to give exclusive breastmilk.
Next steps: Soon I was able to practice latching the twins in the neonatal intensive care. They were so small and were not the best breast feeders. It took about a month at home to finally get both babies latching, and keep my milk supply up. With a lot of support both babies were great breast feeders by the time they were two moths old. I was an experienced lactation consultant and postpartum nurse and it was still challenging. With the right support I was finally able to meet my goals. It was hard work but worth the effort. I was happy to give those little three pound twins the immune support premature babies need.