Charulatha, lovingly known as Charu, is a software Engineer with Intel Technology in Bangalore. She loves travelling and is on the move with her kids, at regular intervals. When she is not at work, she spends her time reading to her kids or planning for the next trip. Charu conceived with medical intervention after 8yrs of marriage and is blessed with twins, a boy and a girl, now 4.5yrs. She is an admin on the Breastfeeding Support for Moms of Multiples India (BSMMI) and Truly Spooky Facebook groups.
1.A lot of mothers, due to various reasons, struggle to nurse one baby. How was it for you with two premature babies?
My babies were born at 31 weeks and immediately shifted to the NICU in another hospital. I was just a kilometre away, unaware and happily waiting for them to get well so I could go home soon. Back then, I was quite naive about everything. I believed that they’re kept in the incubator and it would be as safe as the mother’s womb; they are being fed and they will be out in probably 2 days and we will go home and our breastfeeding journey will begin. I did not even know the importance of expressing or pumping till then.
Fortunately, my delivery doctor and the NICU head kept pushing me to express breast milk. I tried, but I had no idea about how to express and what was expected. Nothing came. The 20-year old nurses, although were always ready to help, it was unfortunate that they didn’t know it themselves. They kept squeezing my breasts but their technique left me in severe pain and with no milk.
2. All of that sounds so devastating. So, when were you able to feed your children?
My breasts were engorged and the pain was unbearable and that made it more difficult to express. On the third day, my daughter got jaundice and the NICU doctor said that even a few ml of breast milk would help her get better. I knew I had to do this and I was ready to do whatever it takes. I didn’t even believe I had milk as none of the previous methods to express were fruitful. I waited for my delivery doctor to come and prove to me that I was lactating. When she pressed the breast, the milk began to flow and I was ecstatic. I learnt the technique from her and expressed oddly 10ml of liquid gold. And that was fed to my daughter. My breastfeeding journey began that night.
My sister and a very dear friend mentioned that milk comes as the baby sucks or only if I express for their needs. I kept trying the whole night. I was able to get 30ml of milk. I expressed every two hours and each session lasted for 2 hours, all with my hands. I wish someone had educated me about pumps. The nights were exhausting as I was only expressing with no sleep. I, finally, met my babies on the fourth day. They were both on ventilators and while their struggle to breathe was over, they were still trying to cope with the outside world.
3. Did you do not try to bring your babies to the breast?
My twins used to vomit on my breast every time I nursed them directly as they were diagnosed with Gastroesophageal reflux disease (GERD) and their guts were still developing. Their sucking caused chillness allergies in me as I was on it for almost the entire day. One day I developed high fever and then I stopped trying. In addition, the misunderstanding that my son might not be leaving enough for my daughter turned me into a paranoid mother worried for her daughter’s growth. I had a supportive paediatrician but I still had my doubts. Expressing made me feel more comfortable as it was convenient and I was also aware of each baby’s intake.
It was exclusive pumping for me for 21 months. I was able to pump 1.4l of milk a day until 1 year and then 1l a day until the 18th month. During the 18th month, my kids were hospitalised which led to drastic reduction in pumping sessions. That in turn affected my supply.
Between the 18th and the 21st month, I got just about 10ml of milk after half an hour’s pumping session. The nurses at the NICU suggested a 20 minute limit and an every two hour feed. My kids were NICU graduates. Hence, the two-hour schedule was programmed. Because of express feeding, the bottle time was just 2 minutes for my son since the beginning and my daughter would take 5 minutes. The schedule for direct nursing and bottle feeding is different.
I tried power pumping in the hope to bring back my supply but I was already obese and was on hormonal pills and that too had an effect on my supply.
4. How did you manage to pump when you went back to office?
My previous employer (Texas Instruments) and my current one (Intel) are amongst the best women friendly employers in the world. The companies have a luxurious baby care room that provides facilities for pumping and other necessities. I stored the milk in the fridge and on my way back home I used freezer packs. That was a blessing.
5. Over the course of time, we hear so many myths that we swing from being frustrated to laughing at it. Have you been affected by these myths as you were quite unaware as a first time mom?
I was told that babies don’t understand anything as they are small.
When I was pregnant, I used to talk to my babies – through words and thoughts. I had a small fight with husband for which I raised my voice. For the next 2 days, my son stopped kicking and moving in the womb. He is the same at 4.5 years. In the NICU, I was shocked to see my babies – all of 1.5kg only. While talking to the nurses about their condition, they began to react to my voice. The nurse was surprised too and asked why they were so responsive. I told her it was probably the communication we had during pregnancy.
I was told that I will not have enough milk for twins.
Honestly, I fell for this and for someone without any knowledge about breastfeeding, this could only seem real. But every time I offered formula, my children rejected them. I used to buy a formula tin every 2 weeks and it would end up with family or friends as their snack. Hence, as they grew, I had to express more. I did not face any difficulties while expressing. In fact, I have wasted lot of milk because of not knowing the proper storage methods. In the NICU, they said one cannot use stored breast milk after 24 hours! I used to pour down at least 300-500ml milk a day as they won’t even accept it for other babies. And the reality and truth is far from this. If stored the right way, you can feed it to your baby at any time without a deadline to it.
I was told that expressing for twins is easier as they can be fed by anyone while I take rest.
I express fed my babies for 21 months and loved every bit of it. The cleaning of bottles or storage of breast milk did not feel like extra work. It helped in scheduling and planning very well. Quite convenient actually. The only setback is if there is a change in the existing schedule or pattern. It affects the flow drastically and you need to struggle to get the flow back. It is definitely not the same as a baby’s suckling. If the baby suckles, the flow is restored. With power pumping and / or hormonal pills, it is tough. If you are looking at breastfeeding for a long time, then direct nursing should be your choice. And if you are used to tandem nursing, it is bliss. You get independent of anyone. I had to feed the kids by myself while family took care of the other stuff. But things got better when I switched to a double electric pump that was suggested by a dear friend.
I was asked to give gripe water and Bonnisan for the constant cries.
The truth is every baby cries for long periods. Gripe water was a tried and tested failure with my babies. I took the advice of other experienced mothers and fed them gripe water. It was only later that I realised that it was a mistake as most of their GERD issues began to subside as soon as I stopped gripe water.
6. You are an ardent fan of travelling. How did you manage with your pumping schedule?
That is an experience in its own! I tried nursing then directly when in the car, but it didn’t work out due to their GERD and allergic issues. They would vomit on my breast. So we went back to pumping and carrying stored milk.
When we take national highways, I have stopped at village homes that are close to the highways. Strangers they were to me, and me to them, but they welcomed me with open arms and a warm heart when they knew it was to pump milk for the babies. Some of them would even sit down with me to understand more as all of it was new to them. I had enough pumped milk and freezer packs to manage up to 11 hours of travel, which is the max travelling time we’ve taken when they were infants.
7. Managing one child alone is difficult. You must take a bow for handling twins all by yourself. How has your support system been?
I was an uninformed mother who had absolutely zero knowledge about breastfeeding, motherhood and caring for children. Of course, you learn to swim when pushed into the deep side of the ocean. Survival of the fittest!
I had full trust on the medical system. And, rightly so! My kids are with me due to the medical advancement in our country; from assisting me with ovulation to test tube technology, embryo transfer and then saving them immediately after preterm birth. It was all about being positive through the trials and trusting that they were in the right hands.
My sister and friends were there whenever I needed them. But a special shout out to my dad who took care of me, my children and my home. At that point, I was also going through the toughest time in my life. For the first week, I had hardly slept for 2 hours, but just for 30 minutes at a stretch. After which, the longest stretch of sleep was a max of 2 hours and a total of 4 hours per day, for 2 yrs.
Later, I stumbled upon the Facebook group, Breastfeeding Support for Indian Mothers (BSIM) and found more support. In fact, when my kids’ allergies were beginning to get cured, I was adviced to wean them. But thanks to BSIM, I knew better.
8. What will be your advice to mothers of twins?
If you wish and are determined, there is nothing that can stop you from breastfeeding your twins (unless of course there is a medical condition!). Don’t let anyone tell you otherwise. When in doubt, always reach out to the right people for help. You are your own boss. Stress is known to affect supply. So ensure that you eat well and you are taking care of yourself.
In the initial days, get yourself a twin feeding pillow. Once you have settled down in your breastfeeding journey, master the art of tandem nursing. Will save you on a lot of time and energy! Nursing while lying down will also reduce a lot of stress and gives you the chance to rest. Get as much help as you can. Ask your husband, family or caretakers to help you with the babies or getting things to you so you get ample rest.
Having twins does not mean you need to depend on others or confine yourself within the 4 walls of your homes. For the car, pick up two car seats. For other modes of travel, get two ergonomic and tested baby carriers or a twin stroller.
9. It is important for mothers like you to come out in the open and spread more awareness about breastfeeding twins, in particular. And you have been doing your bit too. Tell us more.
As the admin of BSMMI, I have had opportunities to conduct many meetups in Bangalore. The response was amazing initially, but it seems to be going down with every month. It is sad to see how the marketing gimmicks of formula companies are winning over the most natural thing, breastfeeding. We are working on more strategies in spreading awareness.
Until last year, we have conducted a Flashmob in Bangalore with 50 mothers dancing with their babies (with no sponsors) and many more breastfeeding awareness programs. We even participated in the Big Latch On, which is on an International level. In fact, during the latch on, when my kids saw other babies latching on to their mothers, they wanted to. And we tried tandem feeding at that time.
As the BSMMI group admin and as a mother, I am going to continue to spread awareness as much as I can as I believe there is nothing in this world that can replace this liquid gold!