Breastfeeding twins - the financials

You often hear proponents of breastfeeding assert that it is "free" - while the actual milk is free, the methods of extracting and storing it, particularly for working moms, can add up quickly. I've assembled a list of my estimated purchases to breastfeed twins through seven months.  This is not a "must have" list - just a list of what has worked for me up to this point.

1. $190. Breast pump - A necessity if returning to work or if you have inefficient nursers. I got my Pump In Style advanced on sale for $190. Here it is in use. It looks really gross, I know.

Side note - your insurance may cover a breast pump due to the requirements of the Affordable Care Act. Because the ACA just requires coverage of a pump and does not specify what kind, your insurance may offer you a single hand pump, like mine did. I passed on that, although I've heard some people actually have better luck with hand pumps. 

2. $200. Second breast pump. After being back to work for two days, I decided there was no way I was transporting a pump back and forth every work day for the next 9 months. I found a PISA metro bag on Craigslist, still new in the box, and bought it for $200. This is my at home/travel pump because the "guts" of the pump are removable from the tote bag in a separate bag. I can leave it sitting on my nightstand or toss it in my suitcase for trips, and I don't have to transport my work pump back and forth. I never use the included tote bag. 

3. $12.99. (?) Cooler bag.  I pump approximately 30 oz during the work day - plus I store my pump parts in the cooler between pumping sessions. The small black cooler that comes with the pump just isn't a great option for me.

4.  Free -(well, paid through my hospital bill) the small 80mL containers (and extra tubing, flanges, etc) for the medela pump. Because I pumped in the hospital, I received like 8 of these - I use them frequently, as I only freeze BM in 6,8, and 10oz quantities - so I'll store the overflow in these to reach even quantities for other pumping sessions. It's also helpful to have the extra flanges, valves, etc so you aren't constantly washing parts. 

5. $12.99 - Munchkin high capacity drying rack. I hand wash my pump parts because we only run our dishwasher intermittently. This drying rack holds a TON of stuff in a relatively small area. Skip the boon grass. Seriously. 

6. $13.99. 100-count Lansinoh freezer bags. (Multiplied by 4). I pretty much freeze all my pumped milk each night, except for the odd bottle here and there, as daycare will prepare bottles and take milk frozen in any quantity. I bring in about 150oz frozen at a time. Note - I routinely put 10oz in these bags, even though the max measurement on the bag is 6 oz. In all the bags I have used for the past 4 months (about 18-20 a week, probably) I have had two leak. Not bad. 

7.  $35. Hands-free pumping bra. I know some people cut holes in an old sports bra, and when I forgot my hands free bra in a hotel room, I did that for a few days to get me by - but for working, I find the hands-free bra much more convenient. 

8.  Evenflo BPA-free 8 oz bottles - 12 pack. I bought two of these when I had to travel for work - I used one set to transport my pumped milk home, and I used the other set to store fresh milk in the fridge for DH, as I wasn't sure how many ounces the girls would take for feedings when they normally nursed. These bottles are compatible with the med.ela parts, so I usually use one of these for pumping, too, as I occasionally overflow the 5 oz bottle otherwise.

9.  AA batteries. The little battery pack is handy for pumping in the car in a pinch, or in an airport bathroom stall...

I'm sure I could think of other expenditures, but these are the things that have made being a working, occasionally traveling, nursing mom of twin infants easier. 

Traveling while breastfeeding - aka pumping in an airport bathroom

I've had to take a few trips for work since the babies were born. This is tough, for two reasons: (1) pumping and traveling with breast milk, and (2) ensuring care for babies while I'm away. I have gotten completely comfortable with caring for both babies on my own - dr. appts, overnights, etc. Is it tough? Yes. Is it doable? Definitely. Kudos to single moms of twins, though - I'm certainly glad I don't have to do it all the time. Although DH has become more comfortable with caring for the girls on his own, so far the overnight care has been pretty daunting for him, so my mom usually comes to help out. Luckily my work trips are usually somewhat flexible so I have been able to plan around DH's schedule and my mom's schedule.

 My trips have been for one overnight, two full days - I'm not comfortable with anything longer than that yet, and I think the amount of milk I would have to bring back for anything longer would be prohibitive - a two-full day trip is 100oz plus pumping and dumping some... 

 For the few days prior to my trip, I don't freeze any milk, and instead store it in the fridge in 8oz Evenflo bottles, numbered 1-9 or 10 so DH can easily tell which is the oldest and should be used first. This allows him to prep bottles with the least amount of hassle, and he can always give an additional ounce or two without having to defrost extra. This was especially helpful for the first trip where I wasn't sure what the girls would drink in their "at home" bottles. (SB in particular goes on a bit of a nursing strike when I'm gone). Here is my packing list for pumping while traveling: 

 -handsfree bra 

 -medela pump - "pump" only, plus wall adapter and battery adapter 

-nursing cover (in case you have to, in a pinch, pump in public) 

-medela cleaning wipes 

-zip lock bags (for storing pump parts in between pumping sessions) 

-large hardside cooler. I think this keeps things colder than a softside, but it may be more difficult to stow under your seat on the plane - I use one that still has a canvas exterior and shoulder strap so I can carry all the other items for pumping. My pump and pump parts fit in the main section of the cooler. 

-12 8 oz evenflo bottles These don't have screw on caps, but I use the medela ones - I have almost 12, and I use the inverted nipple/cap combo on the few remaining. You can buy extra caps, I believe, but I haven't searched to hard for them since I don't need them often. 

-ice packs 

-pump parts - one full set. I usually plan out my pumping so that I can pump and combine bottles and use every bottle for storage. I don't combine cold and freshly pumped milk, as I believe this is a no no, so this sometimes takes some coordination. 

-dish soap to wash parts at the hotel 

-2 80 mL snap-lid containers 

-8 AA batteries 

 -hand sanitizer 

 My trips have, for the most part, gone off without a hitch. A few things I've learned: (1) Nursing/pumping will allow you to travel with breastmilk in excess of the 3 oz rule. You also can bring items greater than 3oz if they are frozen solid when you pass through security. They will test a random number of bottles, depending on the volume you are traveling with - they no longer open the bottles or use the paper strips. 

(2) The TSA website says you should tell them a TSA agent if you are traveling with breastmilk. Even if you do, they will still run it through the xray without telling anyone else, you will have to tell the person operating the xray that you are traveling with breastmilk, too. 

(3) Make sure you ask for a fridge for your hotel room, and make sure it will be turned on and cold prior to your arrival. Also make sure that it isn't so cold that it will freeze your breast milk - if you freeze then thaw breast milk, you have to use it in 24 hours. 

(4) airports are surprising unfriendly for pumping. If you can find a family restroom, use that. Otherwise, sometimes the handicapped stall may be your best bet, or a quiet corner under a nursing cover. 

 (5) Don't be afraid to inquire about time and a place to pump at your destination.

(6) people will be very curious why you are traveling with a large cooler. 

(7) plan to nurse as soon as you get home if possible - even if it's a dreamfeed. 

Breastfeeding twins - the first few weeks

As I stated in my prior post, during our hospital stay post-delivery we had an assertive nurse who got me started on a nursing schedule to make sure I was getting rest. Basically, I was to nurse the girls every three hours, each for 20 minutes. I guess a nurse tried to teach me to tandem nurse in the hospital - I have no memory of this. I simply wasn't functioning well enough to make tandem nursing work yet. BW also was struggling with latching, ineffective sucking, and falling asleep while eating, so if I tried to tandem, I imagine she probably didn't eat anything. Once I finished nursing each baby, I would then pump for 10 minutes. 

We also utilized a supplemental nursing system- basically a syringe with a thin tube attached. This thin tube can either be placed next to the nipple or used with a fingertip to get the baby formula/breast milk without causing nipple confusion. We used this both during nursing, primarily with BW, to stimulate her sucking, and after nursing with both girls to supplement. I say "we" because DH helped with both - he handled the finger supplementation while I pumped. We initially supplemented with formula the first few times, but I soon was pumping enough colostrum to use for supplementing. Our instructions from the lactation consultant were to supplement using a certain number of milliliters based on how successful the nursing session was.  

This system seemed to work fairly well - until we were informed by the lactation consultant the day we were to be discharged that it was working too well, as SB had gained 5 oz in 24 hours. We were told to reduce the amounts that a were giving to supplement. End result? We had two miserable days/nights with two miserable, hungry babies before we went back for a weight & jaundice check - when we told the lactation consultant what had been happening, she told us we could supplement the babies until they were satisfied - understanding 60 milliliters, or about two ounces, was about the max they should have. 

Supplementing was a guessing game that made me doubt myself as a mom and caused some tense moments between two sleep-deprived parents. DH would ask me how much he should use to supplement, based on how the baby nursed. I would guess, and hated having to make any decisions when I was so tired. 

In the end, the nurse/nurse/pump/wash pump parts/supplement schedule took about 90 minutes, out of the every-three-hours schedule. Zombies. We were zombies.