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Ep. 139- Breastfeeding TWINS- Interview with expert Lindsay Castiglione, BS, IBCLC

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Ep 139 Breastfeeding TWINS

This is Maureen Farrell and Heather ONeal and this is The Milk Minute. We’re midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships, and mental health. Plus, we laugh a little or a lot along the way. So join us for another episode.

Heather: Welcome to the Milk Minute Podcast everybody. Welcome. We have a twin expert today. December 18th is National Twin Day, and we thought, what could be better than dedicating an entire episode to our lactators who are twinning? From the time we see those two little electrical impulses flicking away on the ultrasound, it’s game on with preparation for double duty.

Most of us can barely manage one baby, and then we see these superheroes toting their multiples to target, and we are absolutely dumbfounded. So how can you even keep track of any of the stuff like, thank goodness most of us are born with two boobs to feed those two mouths. However, things inevitably get complicated when we’re pulling these double booby duties. And we thought we would bring on a twin expert today, and she is fabulous.

She is an I B C L C who actually has two sets of twins herself, so let that sink in for a second. Two sets of twins. We have questions and I’m sure you do too, but before we bring her on, quick reminder. Maureen and I both do private lactation consults and those links are always in the show notes and we would love to thank some patrons.

Maureen: Yeah. Today I’d like to thank Lauren V and Holly S. They’re some of our newest patrons and we are so thankful for their support. .

Heather: Yeah. Your support helps keep this podcast going and helps this information become accessible for free to everyone. So you can support us for as little as 25 cents an episode, and you get all kinds of awesome stuff behind the scenes access and early and ad free episodes, all kinds of goodies.


Maureen: So head over to podcast and join us. Okay. So we have an email from a listener that I. All right. Hey, Heather and Maureen, I just started listening to your podcast when I went back to work last week and wanted to reach out. I’m sure you get bombarded regularly, but I just wanted to say thank you and let you know your podcast has positively impacted me, aside from my general enjoyment during my pump breaks, which definitely helped.

Distract me from feeling guilty about pumping at work. You two have definitely helped me work through some issues. I went back and listened to your podcast episode about sex, and I just wanted to let you know that I appreciated the candid conversation. It’s hard to know who to talk to about issues in the bedroom, and I was feeling very alone and very broken, even though most of me knew it wouldn’t last forever.

Your podcast. My husband and I figure out a plan to move forward in this area, and I’m so glad to know I’m definitely not alone. Thanks for all the support from Amy from Michigan. Isn’t that sweet? That’s so sweet. I’m glad it was helpful. You are definitely not alone. Everybody out there who is struggling with your libido, you are not

Heather: alone.

Yeah. Libido, body positivity. Boundaries being over touched. It’s a hot episode, like mm-hmm. , we get into a lot of different things. People, I think we also had a little bit of wine, so it’s a fun, listen, , we used to have time to have some beverages when we first got into podcasting. I was still editing the episodes back then.

The good old, old days. Apologies in advance. For the audio quality, but the content is gold. But go listen. It’s a

Maureen: great one if you haven’t listened already. Okay, well, let’s take a little break to thank our sponsors, and when we get back, we’ll be welcoming our guest today.

Heather: All right. It’s Maureen here, and

Maureen: I want to tell you that I have, Finally set up a link so you can instantly book virtual lactation consults with me.

Heather: Thank the Lord .

Maureen: I know Heather, it took me a long time to take the leap from in-person visits to virtual, but I did

Heather: it. You’re gonna love it. I love doing virtual consults.

They’re the best. It serves more people. I’m so glad you took the plunge. Thank you. And if

Maureen: you guys out there wanna book some time with me, you can go to Highland. and then click on my lactation services tab.

Heather: Is that H I G H l A n D? Yes. Okay. .

Maureen: I will see you on Zoom, everybody.

Heather: All right, listen up. All you people who are expecting twins, currently feeding twins. . We’re currently trying to figure out how to feed one baby and thought that this twin episode would give you an extra edge. We have a really cool twin expert and I B C L C on the show today. Lindsay Castile, yep. Is the owner of Full Heart’s Collaborative, a multiple lactation practice, and she’s extremely fun to follow on Instagram.

So if you and TikTok. And TikTok. So if you have not followed her those two places, please go do that. She is such a gem of a resource for families with multiples. Lindsay, welcome to the Milk Minute

Lindsay Castiglione: podcast. Thank you for having me. I’m totally like fangirling out right now. Like I listen to you guys. all the time.

I think I’ve listened to every single episode actually. .

Maureen: We love that. Okay, Lindsay, let’s start at the beginning. Can we just take a minute to normalize complicated feelings that we have when we see two babies on an ultrasound? Talk to us about that moment and maybe the other questions that come up in your brain as it sets in that you are having.

Lindsay Castiglione: Okay, so with the two sets, there were very different reactions. So I’ll say that the first time we had done fertility treatments, we did for both sets, but I’ll get into that in a second. You know, I had the typical questions like, you know, what kind of gear do we need? What can we avoid? So our house doesn’t like look like a daycare , you know, just finances, that type of thing.

But we had known that I was gonna stay home with them, so that was helpful. But the pregnancy was very complicated, so it, it started out super exciting. And then at week 16, they kind of give us some not great news about the way they shared the placenta, so they didn’t share it equally. And so one baby was really, and that kind of governed the rest of the pregnancy.

So I delivered them at 30 weeks. So very early, you know, and it was, it was tough having preemies just in general and then having two of them and being a first time mom. Mm-hmm. . Oh my gosh. Yeah. But we are military and we knew that we were going to get transferred when our boys were gonna turn about two, and we wanted to have one baby, one more baby , and find out what that was all about, you know?

And so we liked the fertility clinic that we had used, so we decided to kind of push things a little bit sooner. and do that transfer of the embryo before we moved. So I V F is complicated, but when we went in on the day they were gonna transfer the embryo one embryo back to my uterus, the doctor kind of made like this grimace face and he was like, yeah, I really think if you want like a chance at one sticking, you should put two back.

Oh yeah, yeah. So we had like this tough decision over, do we want. , would we rather have no more babies or two more babies, ? And ultimately we decided that we would take the chance on too, knowing that, I mean, all things considered the chance was pretty low, that they were both going to. Stick anyway, that either even one of them was so fast forward, we go to the first ultrasound.

I was totally like; this is one baby. We had had the H C G drawn and it was like in the one baby, you know, in the, in the frame of reference for the numbers. I was like, we did it. We have a one baby. So we go in and I will never forget the ultrasound tech. She goes, so how do you feel about having your second set of.

And I was like a deer in the headlights, like . That’s it. I like so many thoughts and fears and you know, with the first set, like you can have like an ignorance is bliss kind of thing. going on. Mm-hmm. . The second time I knew how much work it was and my only frame of reference was a complicated premature delivery.

So it took me a while to be honest, and that is something that’s still kind of hard to look back on, and I think a lot of parents feel that way, especially if these were unexpected, you know, twins or a pregnancy in general. And then also if you have an older child or older children, because one of my main worries was I’m gonna be taking my toddler’s mother away from them.

Basically, you. anyway. It was, it was tough. In the beginning I was really sick, but once I found out the genders, and I don’t even really think it was about what they were gender-wise, but it helped me like wrap my head around things a little bit more. I started to get excited. So our second side, as a boy and a girl,

So from then on, you know, it was like cool. At that point, like I was like, all right, we’re gonna be a unique family. We’re gonna have two sets of

Heather: twins. Yeah. I mean, thank you for being so honest about that, because I think that. any surprise, pregnancy, and sometimes even surprisingly planned pregnancies, we don’t feel that connection right away.

Or the sense of dread outweighs the sense of happiness compounded by outside people saying things like, aren’t you so happy ? Aren’t you so blessed? Wow, isn’t this just God’s purpose? And you’re like, I. Don’t know if it is , you’re like, you know we’ll see. You know, we’ll see. And I had a midwife tell me once when I was very worried that I was not going to love my baby , you know, my first baby.

That was a surprise. And you know that first trimester where you don’t really feel pregnant, you just kind of feel gross all the time. It’s same. Yeah. Like this is what it is. . Yeah. And, and at my prenatal appointment, I said, I don’t feel anything. Like what if I. like, love this baby, right? And she said, she said, oh, that’s okay.

And I said, what do you mean? And she goes, oh no, it’s fine. Like everybody’s different. She said, the longest I’ve ever seen it take is about four months postpartum. And you know, of course we just get involved and we do meds and like, There’s stuff we can do. And I was like, oh, so there’s a plan. And just the way she said it was like so reassuring.

So thank you again for your candidness on that. And I think probably it’s even, even more pronounced with twins. So it was, and I think we have that foundation. I think

Lindsay Castiglione: the infertility factor too plays into it. You’d assume, you know, doing fertility treatments, that you’d be 100% thrilled. You know, like that would be the ultimate goal.

And in some ways I kind of felt like my infertility robbed me of knowing what one baby was gonna be like because mm-hmm. , you know, it was obviously a higher chance that we were gonna have twins. And again, like now I look back and I feel horrible because I would never wish away one of my kids, you know, like obviously I love them.

But yeah, that was, it was tough to

Heather: swallow. Well, yeah, I mean it’s like your whole body. I mean, naturally we’re kind of like built to be a little selfish when it comes to potential harm to our physical being because, and you know when, when you’re on bedrest or whenever you have, when you know that something is not quite, Going right in your body.

You know, it does kind of kick you into this more primal mindset of like, protect thy self. Right. You know, which kind of can get in the way. And just to clarify, were you in I B C L C before this? Oh no. Or did you become an I B C L C after? Yeah. Yeah. This is, let’s get into that. Tell me the story about how we became a lactation consultant.

Okay. I’m assuming it, it is rooted in all the like pumping and the NICU Yes. And the latching.

Lindsay Castiglione: Yes. . So you can imagine trying to breastfeed twins born 10 weeks early was like, probably the hardest thing I’ve ever done in my life. But I was so stubborn. I was like, I’m going to, I’m gonna do this. All right, so, when we had the twins so early, I honestly was not even sure I was gonna be able to breastfeed them at all.

But I had this amazing NICU nurse and she kind of took me under her wing and walked me through it. And I was very lucky in the sense that like my body cooperated, but it was still hard. Like, you know, you’re feeding a pump for. weeks on that and until you can latch and it was just had a lot of challenges to it.

But when they were discharged, they were exclusively breastfed. And I had them latching, I’d say about 50% of the time. And like pumping nice work and doing bottle feeding. Yeah, it was, it was something to be proud of. Right. So yeah, they asked if they could give my information out to be like an informal peer supporter for other families that were trying to feed their twins in the NICU.

Because you had so much free time.

Heather: Okay, go ahead.

Lindsay Castiglione: Right. But I’m one of those people that I’m like, I don’t even think about that. I’m like, sure, pile it on. Like just gimme like a million things to do. You’re in

Maureen: good company.

Lindsay Castiglione: Yeah. I was thrilled though. Like I was like, oh, I’m, of course I wanna, I wanna be that source of support, like that NICU nurse was for me.

And so I did that, you know, for. A couple years, they would still, I would still get emails, but when I was pregnant with the second set, I was. , I’m just gonna formula feed them like, which makes me laugh now cause that’s not how it worked out. But I was like, I, I could not imagine cuz my frame of reference was just feeding preemies.

And I was like, I can’t imagine trying to do that and have two toddlers like, no, this is not gonna work. Oh my gosh. Yeah. Yeah. But they were born at 38 and two. He was eight pounds holy, two ounce ounces. Holy cow. And she was six pound 11 ounces. So they were like 15 pounds combined. . . Yeah. . So I’m like, all right, well we’ll give this a shot.

You know? Cause they were term quote unquote, and so they just took off running with. nursing and I, they never had a drop a formula, nothing. They just, and they nursed till they were 27 months.

Heather: Oh my gosh. Nice. . That’s amazing. Did you have a c-section? Do

Lindsay Castiglione: you mind if I They did, yeah. Both times. The second time was an intended V a c, but my baby a was breach, so

Heather: yeah.

Yeah. They do that in there. There’s just not enough room for all the butts and heads I

Lindsay Castiglione: know. Yeah, it’s true. It, it does happen a lot. So, and they can turn way. People don’t realize, but yep. , I had, she switched, she flipped Vertex at like 34 weeks and I was so excited. And then at 36 she flipped back. And that is uncomfortable.

That does not feel good. Oh,

Maureen: yeah. Oh yeah. I’ve seen it happen between a prenatal on a Wednesday and a labor on a Friday. .

Lindsay Castiglione: Yeah. Okay. So after that I, after that whole experience, I actually wrapped up, Our breastfeeding experience between the second set and myself so that I could go to a CLC training and I ended up starting to work for a company that was called Twin Love Concierge, and they did like twin online classes, so like expecting twins and breastfeeding twins.

And so I started teaching for them, loved it, and decided to work towards the I B C L C. Now my husband’s active duty Navy, and so we moved. Oh, nine times since my 11 year olds were born, so gosh. Oh, wow. , right. So it was a lot of like kind of getting a class done here and getting, you know, some lactation classes, you know, for the credits done there, just like piecing things together.

And then I got my hours through working for WIC. So then I did the whole, like, studying for the exam and then I took it and passed it, and I opened my practice in 20, early 20, 21.

Heather: So how old were your, your second set of babies when you opened your practice? Oh, they

Lindsay Castiglione: were seven.

Heather: Wow. Okay. Yeah. So, so you had a lot of parenting under your.

Okay, well listen, there’s the people that are listening to this right now are like, they have their notepad and their pencil . They are trying to control the uncontrollable, and we’re going to give them some nuggets, if that’s okay with you. Yeah, yeah. I’m excited. So, at what point did you, and do you recommend others begin to consider and prepare for breastfeeding twins or a feeding plan for twins at all?

And is there a quote unquote right way to prep? .

Lindsay Castiglione: Well, you know, everyone has their own way of doing things of course, but I have a way that I recommend, so I’ll tell you about that. So I think the first trimester just gets, just dive right into it, you know, right from the beginning, you know, not taking a class right away, but I think definitely start thinking about what feeding two babies might look like about, you know, how you feel about feeding them.

like latching them versus pumping, you know, just kind of explore your feelings around it. And then also listening to the milk minute or any other, like breastfeeding, good breastfeeding podcasts following social media accounts, that type of thing. Just to kind of open your awareness to more of what breastfeeding twins might look like, or just breastfeeding in.

So then second trimester, I like people to call their insurance company. So calling and asking about like any lactation care coverage that they might have, their pump options if they cover classes, like all that kind of thing. . And then also talking like deep, deep down talks with your partner, if you have one, about how your family is gonna take this on, because it is a huge undertaking.

You know, I think Feeding one baby is, but two is. twice, if not exponentially harder. And I love talking about this in my classes cuz the moms are always like, yes. Say more, say more when I’m like talking about all the things the dad should be doing or the partners should be doing ,

Heather: but we, and they’re like, why aren’t you taking notes

Yeah. Why am I the only one taking notes? You should be the one taking notes. I’m growing the

Lindsay Castiglione: babies. Yeah. Or when I talk about how like it’s mandatory that they. Overnight for feedings. Mm-hmm. . Yeah. The mom’s still like, yes. Yes, that’s exactly right. And again, it doesn’t work that way for every family, but you know, for the most part.

So talking about like division of labor, like the partners are really gonna be doing most of it, you know, laundry and cleaning and cooking and all that, while you’re pretty much nursing these babies or pumping like around the clock in the. Taking a breastfeeding class, obviously. I mean, I teach them online, so I’m, I am one resource for those, but I just can’t imagine delivering twins, planning to provide milk for them and not having any like framework of.

how this is supposed to go. So take, well,

Maureen: I think unfortunately a lot of people are there, . I know. But hopefully this podcast episode will get to them. So I imagine that you get a lot of questions from people. What are the most common ones you get? I assume people are asking a lot, you know, can I make enough for two babies?

What else? What else are

Lindsay Castiglione: people worried about? Yeah, that’s definitely. , you know, top way up there on the list. They also, I have a lot of parents that want to combo feed, but they don’t know what that looks like and they don’t know how it works. So they, but they know that they want someone to be able to help them in some way.

So how do we do that also about their mental health. I think that’s a huge concern about people expecting twins. They hear parents of one baby talk about how. hard breastfeeding was on their mental health. And like we know that that’s often, it’s not the person or the person’s mental health, it’s the lack of support and resources and everything around them to help support them.

Mm-hmm. for each. Yeah. So that’s times two. When you have two babies, you know, like you, that’s a real concern a lot of people have. And so yeah, we, I talk about that openly in my classes that it’s not. , it’s protective against postpartum depression and anxiety in the right context, you. Yeah,

Heather: it definitely can be.

And it’s also helpful to just have somebody to check in with, you know, setting up that support early. That way if you start to feel yourself slipping, you can check yourself with that person and be like, is it me? Am I crazy? And that person can go, no, no, no. Like literally no one’s showing up for you.

right? Like, you haven’t

Maureen: slept in 14. Or on the flip side, Dave, he’s like, yes, what you’ve said is absolutely irrational and we need to figure out how to manage it.

Lindsay Castiglione: that happen. Yes, 100%. Yeah. It. twins are 43, or mothers of twins are 43% more likely to. have some sort of postpartum mental health

Maureen: challenge.

Yeah. Surprised I am not, yeah. That’s twice as many children .

Lindsay Castiglione: Right. It’s, that makes sense. Yeah. Yeah. Unfortunately. So I think that is, that’s something that a lot of parents are really worried about and like how to get them on the same schedule. I get that all the time cuz they hear that that’s the best way to do it.

And I’m not opposed to that. I have ways that I work that. , but it’s, it can be tricky in the beginning. It’s not always set in stone from day one , so,

Heather: yeah, for sure. Well, so what do you tell people when they ask you questions about their body’s ability to do it? To make enough milk for two, you know, because the way I say it might not be as well received by someone who’s actually pregnant with twins.

So for someone that’s had two sets, what language are you using to encourage these people to trust their gut.

Lindsay Castiglione: So we’re made to feed our young, right? So our body biologically has a way of creating a milk supply for two babies. So it’s absolutely intended for you to have enough milk. It’s again, like the things that come into play that can.

Potentially impact that. So we have to minimize those outside, you know, like a lot of supplementing without the pumping to back it up. That happens a lot with twins or just other situations that, that you can find yourself in. But you know, if all things are going well and your body’s getting the stimulation to feed these babies, Responsibly or on demand, however you wanna call it, then your body should make enough milk for both of them.

Now that being said, there’s a lot of, a lot of people who end up having multiples as a result of infertility, right? And so we know that hormones and fertility and milk making are all kind of connected. So there is a certain. portion that I would say is higher than singleton families, where there’s a hormonal aspect that, that their bodies may need extra considerations.

You know, it might be a little bit harder for them to make enough or two. And we

Maureen: have a higher instance of having premature babies with twins too. Absolutely. Right. So those NICU stays and separation from babies, we all know that that can really play into establishing that supply, especially in the first, you know, three to four days when it’s so key to be responsive, right, with how much milk you’re

Heather: feeding.

Yes. And also it does not help that at every single visit with your provider, with twins, I’m sure you’re getting treated more medicalized and you know, more like, you know you’re automatically high risk because it’s not actually normal for our bodies to carry more than one baby at a time. Mm-hmm. , did you hear that a lot?

Lindsay Castiglione: Oh yeah, absolutely. That’s. , the amount of clients that I see who were just given formula in the hospital, just automatically like, oh, we give twins formula. Yeah,

Heather: let us help you out, . Trust me, you don’t wanna do this with breastfeeding. Let us help you. Yeah. And I really think that that’s kind of bullshit to be honest, because.

You know, like from go the minute you, you become pregnant with twins, you are treated like you’re abnormal, right? You are. All these little seeds of doubt are planted at every single prenatal visit about what your body can do to even grow the babies. And then you cross that hurdle and you’re like, I did it.

Mm-hmm. , I grew ’em, they’re out. Look at me. And they’re like, yeah, but maybe because of your age. I hear this one a lot and a lot of our IVF people, 40 and they’re like, well, because of your age, you’re probably not gonna be able to make milk. Not true. We have not seen that in the research at all. In fact, I have people in their fifties who are making plenty of milk for their babies, and I high five them virtually all the time.

That’s amazing. Yeah. You know what I mean? And it’s just, and then also you’re more likely to have interventions, inductions, which lead to C-sections. C-sections can limit milk supply because of swelling. So it’s like, is. The chicken or the egg. Exactly. With milk supply, with the situation. So I would say, you know, for me best bet is to just try to keep in mind that you are normal, that you’re already doing it, that your hormones have figured it out as far as keeping the babies.

in their cooking. So like, let’s have faith again that we can do it with the milk. Yeah. So isn’t

Lindsay Castiglione: that so hard though? It’s so hard to trust our bodies to do this huge thing. Honestly, the biggest concern that I have for clients as a lactation consultant is burnout. That’s even bigger than supply concerns.

It is so hard, so hard. The majority of families I work with are triple feeding without any clear plan when they come to me. And you can just imagine like your nursing babies individually. So I’ll get into that in a minute about like tandem versus individual feedings, but each one say just say 20 to 30 minutes each, and then they finish feeding, and then you have to pump, and then they’re supplemented and then they’re hungry again in like an hour.

So hard in the beginning and then you have

Maureen: to wash the

Heather: pump parts, .

Maureen: That’s the whole

Lindsay Castiglione: day right there. Yeah, it, it’s easily, that’s why I say like the partner’s really gonna have to do the majority, the other things cuz it’s just what it looks like, but not too, you know, doom and gloom because I know that can sound really like, oh my gosh, I’m never gonna be able to do that to an expecting parent.

Maureen: Well, hopefully, If we can get some information on the front end, we can prevent the triple feeding nightmare. Yes, absolutely. From happening. Well, Lindsay, we’re gonna have to take a break in a minute, but before we do that, can you tell us your three favorite things that twin parents shouldn’t live?

Lindsay Castiglione: Yes. Okay. Number one, a traditional pump. Do not buy a wearable. I see this all the time. Not to say that they aren’t great, but you need a traditional pump first. So Spectra, uni, mom, opera, pumpable, super, genie, you know, all those reputable, like really good pumps. need one of those, even if you.

Hope that you don’t pump at all. You just, you have to have one just in case, a Twinsy pillow or a Twingo pillow. Those are two different types of twin feeding pillows, so I like them each for different reasons, but just a twin nursing pillow in general. and then a hands-free pumping bra. This is super important, like if you’re gonna be pumping and taking care of two babies, you need someone to hold those suckers.

Like you’re not gonna be able to , just walk around, you know, sit there and hold them while your babies are hanging out in front of you. So,

Maureen: well, I hope everybody wrote those down, but if you didn’t, don’t forget, we have transcripts on the website, , so you can look at those and. We will definitely make sure that we write those down for you.

So let’s take a quick break. This has been fabulous so far and I’m super excited to come back after we thank our sponsors to talk about, yeah, whether or not we need to tandem feed, pumping for two, all that kind of stuff.

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Heather: Okay. Welcome back everybody. We are super excited to talk to Lindsay about all of our other questions. Lindsay? Yes. If you could list the three biggest worries that people have when they’re expecting twins. and speak directly to them, lay it out on the table and kind of tell us one by one why they shouldn’t be scared.

Lindsay Castiglione: Okay, so number one is not making enough milk. They don’t know what’s gonna happen and. , it’s hard to have expectations, you know, when you haven’t done something like this already, if you’ve, if you’ve nursed one child already, it does make it a lot easier to have faith in your supply. But like we were just talking about, you know, if you can get all that stimulation in those early days, make sure that you are kind of laying the groundwork for your future supply and nursing those babies.

You know, whenever they show you hunger cues, you’re gonna make enough. almost all the time. Sleep is definitely another huge one. So people are like, if I, if I nurse or breastfeed or pump, I’m never gonna sleep ever again. Well, I hate to tell you this , but you’re not really gonna sleep much anyway. You look at it and the first six weeks or so, it’s kind of like bootcamp.

That’s what I tell people to expect. Like it’s, it’s rough and there have been studies. Feeding times, like how long it took it takes to feed babies, you know, different, different modalities and. , it’s not gonna save any time to formula feed and to bottle feed. So we’re just gonna push through that rough part, make sure you have lots of support and the sleep, we get it when we can and you will not die from sleep exhaustion, it will get better soon.

And then mental health is the next big one. I guess. Again, it’s just something that people hear a lot about how hard it is and they’re not sure they’re gonna be able to handle that. And so again, if you find. resources that can help you out, get a lactation consultant or know at least a name and a number before you deliver, and make sure that the people around you, like your village, quote unquote, are prepared to support you.


Heather: so here’s my

Maureen: big question. As somebody who’s never had twins, but I’m curious. Too tandem feed or not too tandem feed?

Lindsay Castiglione: Yeah, that’s an excellent question. The answer is yes and no. . Perfect darn ask. It’s definitely the goal in most situations, and I do come across patients too that are. You know, maybe a little bit neurodivergent, which like I’m part of that club too, so, you know, it’s not something that’s gonna prevent you from doing this, but sometimes getting touched out with tandem feeding makes it so they just choose not to, and that’s totally fine.

But obviously if you can save the time from feeding two babies and combine it and do it at the same time, there’s obvious Cool, you know, obvious benefits to that. But, It’s really hard in the beginning. It is, it’s, you can imagine, you know, for most people, for a first time parent trying to learn how to feed that baby and that baby learn how to feed is tough.

And with two, I kind of equate it to tandem feeding, equate it to. , like if you’re nursing a baby as a first time parent and then someone says that you’re gonna play a game of catch at the same time and they’re throwing a ball at you and expecting you to catch it and throw it back to them while you’re nursing.

And so you need to be doing like two separate physical and cognitive. Activities because these are two different babies. Like when it comes down to it, like they’re similar, but a lot of times I’ll have one baby that needs help with latching this way and then another baby who can’t handle letdowns or whatever it may be.

So it’s, yes, it’s definitely, it should be the goal. And I have like a, A system that I work through with clients on getting to that, but it. Next level. So something I run into a lot is people assuming that that’s the way that they’re supposed to feed. And they often get the advice in the hospital by the IB CLCs that you have to tandem feed.

That’s the only way to make it work. If we just expect that we’re gonna be tandem feeding all the time, it’s, it’s gonna lead to burnout. For some people, and I, I don’t mean to make it seem like it’s one size fits all. Like there are some people that start tandem feeding. It works out great, the babies are gaining, everything’s going well, and they ride off into the sunset, you know, with their, their tandem twin pillow.

But for most people, what I do recommend is if you can get that first latch in a tandem feeding session that. Awesome. That would be like sunshine and rainbows, like ideal situation. And there should be support in the hospital amongst nurses and your partner, whatnot, to help get you even with a C-section to help get you into like a tandem laid back position.

But after that, just tandem feeding once a day, just so you’re practicing, you’re just getting like your feet underneath you and just kind of seeing what this tandem feeding is all about until the babies are showing signs. Transferring the milk, well, you know, you’re not in any pain. The supplementing, if there’s any going on, is on the minimal side.

Then you kind of take the cue that you’re ready to really work forward with that tandem feeding goal. And so then you do maybe two tandem feedings a day, and then after a few days you switch to three and then we’re just gonna keep kind of converting individual feedings over until you are tandem feeding as much as you would like to be.


Heather: Quick question. , is it true then, or maybe just correct me here, that the IB CLCs at the hospital typically tell you to try to tandem feed because it’ll increase your milk supply because when both breasts are being stimulated, your prolactin is higher, which is why we always encourage double pumping instead of like pumping one boob at a time.

Is there, is that like why they do it or is it mostly just surrounded, like is it mostly just because they think that it’s gonna save you? .

Lindsay Castiglione: I think it’s both, but I think it, the time factor is definitely a big one. As far as like the prolactin, that’s definitely a bonus. You know, that’s something to be said.

And also with tandem feeding, if you have one baby that’s a more effective feeder and they’re emptying you more thoroughly, then that kind of helps compensate for the baby who is not feeding as well. But if things. kind of not established yet, and you’re more in shaky ground with just the latching in general.

What I often see, and I see this with weighted feedings all the time, babies will take in less, they’ll transfer less milk overall in a feeding session versus an individual feeding. And so we know, like if that happens and they’re not, , the parents’ not being emptied fully and their supply’s not being reinforced.

I don’t know that that prolactin surge, like the extra prolactin is really gonna serve, serve you well, you know, so there’s, it’s just a lot. There’s a lot of moving parts to it.

Heather: Why do you think it is that they transfer more when they’re competing individually? Well,

Lindsay Castiglione: babies. I remember when I first had my first set, and they would come off the breasts all the time.

Like I would latch them 20 seconds later, and maybe this is more so like the preterm thing, I’m sure that had something to do with it, but they would not say latched. So when I started tandem feeding, I would literally like latch one baby. and then be like, okay, you’re, you’re good. And then I’d go to my other side and latch the other baby.

Okay. You’re good. Now, what do you think happens? The first baby’s come off already, and so then you go back to that baby and you latch that baby. Yeah. And it’s like literally like playing interference, like you’re going back and forth between the two of them. So, They’re spending more time unlatched than a, a baby feeding individually cuz they’re waiting for like their twin to be tended to.

So my

Maureen: question, this, this is the thing that would get me , is which boob for which baby?

Lindsay Castiglione: When, oh, I know this is a tricky one. This, this is, the logistics of twin feeding are. I feel like I’m always like doing next level strategizing in my brain. Like trying to figure

Maureen: out like what I feel like you like need a spreadsheet.

Yes. You’re like, okay, lefty twin A, and then righty twin B, and then we switch. And then, but like, you know, for me, I have a huge supply discrepancy from side to side. You know, I make like half an ounce on the right and two ounces on the left, like, Those are not the same feeds. I can’t imagine trying to give an equal amount of milk to two babies with my unequal

Lindsay Castiglione: boobs,

Right? So that’s one of the reasons. And also sleepy babies that I always encourage switching halfway through. Some people think like, oh, I’ll just feed this baby on the left and that baby on the right and then the next feeding I’ll switch. But I often have them switch. , sometimes even twice through a feeding so that they can try to get more letdowns and try to get both breasts to have the, the benefit of whichever baby is the more efficient feeder.

Well, and


Maureen: guess that way if you did it, you wouldn’t have to remember which side, which time, cuz you’d be doing both. Both times. .

Lindsay Castiglione: Yeah. I mean, not as much I would say. I’m sure there’s. some things and you know, there’s always like the squeeze test. Like, you know, you squeeze which side and whichever Oh yeah.

Feels fuller , you know, and then sometimes it makes more sense to put like, if a baby is struggling with weight gain, like trying to give them your fuller side more often. So there’s so many ways to do it, and that’s definitely one of the biggest things that I do with, with families is the strategy. .

Heather: Yeah. I mean, I, what sucks is that there’s like no A plus B equal C.

No. Nope. and, and if you’re still pregnant with twins, it’s like a lot of it is, well, we have to wait until we meet these kids. Mm-hmm. , you know, when we meet them and we kind of see what’s going on and we understand your new post postpartum body, then we can make a plan. But making that on your own with no sleep is probably impossible.

So like, if. One thing that I want you all to remember, it’s that you should establish prenatal Yes. Lactation care. Absolutely. If breastfeeding is part of your goal at all and you know it, it doesn’t stop there necessarily with the challenges of, I think a lot of people are planning to go back to work outside of the home.

With twins at home. So let’s talk for a second about going back to work and pumping schedules. So people with twins who maybe they don’t tandem feed, maybe they feed each individually. Do they pump each individual breast? Like do they pump the way they feed at home? Are they supposed to make that match or, you know, what’s your recommendation there?

And do you often see people lose their supply whenever they start pumping as opposed to feeding twins directly? So,

Lindsay Castiglione: no, not necessarily. The first thing is you have to make sure that your flanges fit correctly, , because if we wanna like support a supply for two babies. Yeah. Huge big deal. So staying on top of, and you would definitely pump both at once.

Like twin moms. We are masters at two things, you know, multitasking. Two birds with one stone. So we’re gonna pump both sides, I would say. The biggest concern that I run into with families, like when they go back to work is that if the childcare provider is not pace feeding, they’re like blowing through the milk and it’s like times two.

And then so the parents at work, like in this rat race, trying to keep up with however many ounces they’re taking it at childcare. So that’s always a big conversation is like making sure that they’re pace feeding what is an appropriate feeding amount. You know, we’re not feeding our babies. Seven ounces or eight ounces of milk , which I see.

But absolutely. Staying on top of the schedule. And sometimes it means waking up even in the middle of the night when your babies are sleeping through when they’re a little bit older. I know, I know. I hate to do that. I preserve sleep. I do too. I’m

Maureen: like, this is my last resort. .

Lindsay Castiglione: I know, but it’s that prolactin piece, you know, if, if mm-hmm.

we’re really having a hard time keeping. With how much we need to, you know, replace into, into the bottles for the day. Sometimes getting up at that like two or 3:00 AM mark, and even just like a quick 10, 15 minute session that could really help make the difference.

Heather: So absolutely. Let’s, let’s make it more complicated.

Let’s talk about combo feeding twins, because a lot of people I think, when they’re pregnant with twins are like, I’m gonna combo feed to take the pressure off of myself in case I quote, unquote fail. But guess what? In my experience with one baby, or any of my clients who are combo feeding, it’s complicated

And then the older they get, the more complicated it is because you have to increase the volume of formula. Yeah. But not necessarily the volume of breast milk. And then, you know, it’s tricky. It’s just really tricky. , you know, I’ve got, I’ve seen it all. I’ve seen people that are like mixing breast milk and formula.

They’re, they’ve got the picture method going on. They’ve got daycare providers that are feeding one ounce of breast milk, followed by three ounces of formula, . It’s like all over the place. So I can only imagine multiplying that by two. So how do you manage expectations for parents that want to combo feed and parents that are actually combo feeding?

Like, are, do you have any tried and. recommendations for that.

Lindsay Castiglione: So the first conversation I have with parents about combo feeding is usually prenatally, hopefully prenatally. And I presented in the way of what are your overall feeding goals? Do you want to feed for a few months? Do you wanna feed for two years?

Do you like what? What kind of overall timeframe are we looking at? And to me that really dictates like, What the early days of combo feeding is gonna look like because we, with two babies, we’ve gotta get that supply hopping, like Right, right, right outta the gate. And if we’re combo feeding a lot, that’s gonna have its challenges, you know?

So that’s one thing, that’s one conversation. But as far as like the, like different feeding volumes, If we just follow the baby’s leads, you know, as far as their waking and their diaper output and how their behavior is, like if they’re acting satiated, you know, they very well may have different volumes, but I think a lot of times, That’s just the norm that you kind of get used to as a twin parent.

And it’s not, that part doesn’t seem as complicated. I’ll say that. So small miracles that seems complicated from

Maureen: here, , I’m like, oh my gosh, I can barely keep track of that for one kid. .

Lindsay Castiglione: Yeah, I know. It’s like splitting your brain into all the time. Yeah. I,

Maureen: I feel like if I had twins I would just have a lot of lists.

like on the wall in my house. Just everywhere. .

Lindsay Castiglione: Yeah. I was a list person. I have a lot of clients though that are app people. They love the app. You know,

Maureen: I ignore apps completely I’ll; I’ll use it for a day and be like, wow, this app is

Heather: great. Never open it again. Yeah, I’m the same way. I think that’s because we’re like pushing towards geriatric millennials.

Exactly. Ouch. That hurts. Sorry. And also, we’re kind of old souls to begin with and we just can’t be bothered with. New technology . Well, I, but some people really do like it. I would

Lindsay Castiglione: turn it on when I started nursing a baby. Like okay, it’s left side. Mm-hmm. Cuz there are apps out there that do twins. Oh yeah.

And I would do, okay, we’re gonna turn it on now. And then like two days later I’d be like, oh, I’ve been nursing this baby for 48 hours. Cause I would totally forget. You know, you just, yeah. There’s so much going on to try to like input information into one more thing. Is,

Heather: is tough. Yeah. So were your identical.

very different feeders like between identical and fraternal twins. Like do you think that it doesn’t matter that that there’re gonna be differences no matter what? Or did you see that if you were having identical twins, the chances are better that they’re gonna be feeding similarly? I

Lindsay Castiglione: definitely think that if they’re identical, they’re going to.

Follow more similar paths with feeding, especially if their weights are similar at birth, which isn’t always the case. I think people think like, oh, if they’re identical, they should weigh, like, they should both be like six pounds, two ounces or something like that. And that’s not, that rarely ever happens, but usually like they’re, and this, this is like anecdotally in my experience, but.

Clocks, their internal clocks on like feeding times and everything seem to line up a lot easier than fraternal twins. And maybe, maybe the gender part comes into it. But I will say that for my boy girl twins, they definitely fed different, I mean, he was a tank at birth and so. and she had oral restrictions, which I did not know at the time.

I kind of knew, but I trusted my pediatrician, which that’s probably a whole different show, eh? Yeah. . .

Heather: We’ve all been there.

Lindsay Castiglione: Yeah. Yeah. So, but I think he drove my supply for the most part. So I definitely, there was a benefit there for sure, for us. But he definitely,

Maureen: you know, it’s interesting. , we, you know, have some evidence that our, like contents of our milk are a little bit different whether we are feeding a boy or a girl.

Yeah. So I wonder what that looks like if you have a boy girl pear. Oh


Lindsay Castiglione: I think if you go back and forth, you know, if you’re switching all the time, which bras, then your body won’t really figure it out. Maybe. But I, I wonder if it would make a difference if you assigned a baby abreast if that would be more likely to happen.

Yeah, definitely. I’ve, I’ve wondered about that.

Heather: Well, it is still the recommendation to not assign a baby of breasts,

Lindsay Castiglione: right? Absolutely. Yes. We do not do that. Oh, good. But that is a question I do get a lot. I

Heather: bet. I mean, that would keep things a lot more simple, but Right. probably not best if only our

Maureen: breasts made exactly equal amounts of milk though, right?


Heather: wouldn’t that be great? And every baby fed just perfectly.

Lindsay Castiglione: And like for an older baby. I will say this, for an for older. Babies for twins. That’s, you can do that. I did that with our second set. Well, first of all, I never saw myself being like an extended breast feeder quote unquote, you know, like 12 months was my goal.

But we know like there’s no reason to stop if it’s working for you. , but we, I had kind of assigned them , this is kind of funny. They just naturally liked one side. Right. And so, but sometimes they would like be up for a wild, you know, wild afternoon. And they, and they’d ask me cuz they were old enough to like, you know, verbalize, Hey, can I have Madeline’s side?

And they, they literally, that’s awesome. Yeah, they just like, I’m gonna try out that side for, for a feeding and just, it’s a little shaken. You

Heather: really mess with them. You could be like, girl, this one’s chocolate and this one’s vanilla. . . Oh, that’s too funny. Well, this has been really wonderful just getting to know you and your story and of course hear your wonderful advice for anybody expecting multiples.

But what is the one thing you want our listeners to take away from our episode? just that

Lindsay Castiglione: it is absolutely possible to, to make enough milk and to provide milk for your twins. It, it might require some flexibility, you know, in, you can prepare and that is awesome, but you might have to kind of adjust and like roll with it once they’re here.

But it’s absolutely possible and that any amount of milk that you give them is amazing. So it doesn’t have to be all or nothing. .

Maureen: Absolutely. I love that. Well, can you tell us where our listeners can find you and how they can work with you and learn from you? Yeah,

Lindsay Castiglione: absolutely. So my business is called Full Hearts Collaborative, so that’s kind of a play on, everyone says your hands.

You have your hands full, you know, to any parent, but especially for twin parents. So the full hearts came from that. And then the collaborative is that I teach all of these online classes that are for prenatal education, so expecting twins and breastfeeding twins, and there’s a couple other ones in there too.

So that whole class schedule and everything can be found on my website. And then I also have all sorts of information there about scheduling virtual consults, cuz that’s the other half of, that’s my collaboration. That’s the other half of what I do. So I see twin parents.

literally all over the world. Like I’ve seen them in Africa and in Austria, and sometimes like they’ll have a local consultant, which is awesome to like help with weighted feedings and latching. But then they kind of just need someone that has that twin experience and can help them do like that strategy part on just some things that make more sense to someone who has done it before.

So all that information is on my website as well. And then I’m on Instagram. Full underscore hearts underscore collaborative, and TikTok, you know, again, geriatric PE people over here, like I am trying my hardest with the social media, but it is so like, not my bag, but I’m, I’m making the effort so,

Heather: We’re all in it together.

Yeah. . And we will link all of your socials and your website in the show notes so people can access that. And thank you so much for coming onto the show. We’ve really, really enjoyed having you today. Yeah. Thank

Lindsay Castiglione: you so much. This is like super exciting for me and I’m glad that I got to talk to all your listeners.

You know, hopefully we get lots of twin parents who listen in and, and this gives them Yeah, some hope. It’s definitely possible. Well, this is

Maureen: a much requested episode, so Awesome.

Heather: All right, everyone, we’re gonna take a minute to thank one of our sponsors. Before we get to one of our favorite segments of the show, the award in the al.

Do you have a baby that struggles with excessive gas, fussiness, colic, and general sleep problems? Well, I did , but

Maureen: then I used a vivo probiotics.

Heather: Evivo is a pediatrician approved probiotic for babies that’s even used in NICU on the Gentles tummies all over the United States.

Maureen: It is an amazing, unique product that contains a specific strain of bien FTUs that we need to digest.

Human milk oligosaccharides.

Heather: That’s actually 15% of breast milk that your baby will then be able to utilize. Whereas if you don’t have the bacteria, there’s so much extra in the gut, which is why American babies poop like 10 times a day more than babies that are colonized with bien infants.

Maureen: I have personally seen this probiotic help my baby and the babies of many of my clients, and frankly, if we’re dealing with any of these symptom, It is the first thing I go to,

Heather: and the best part is it’s not like any other probiotic that we would take when we’re sick or taking antibiotics where you take it every time you go through antibiotics for the rest of your life.

If you give your baby a vivo in the first a hundred days of life, it actually colonizes in their gut and becomes a part of their immune system, which then they can pass to the next generation. And this is how we make change Y’all, Aviva is amazing because it’s gonna safeguard your baby’s health today and give you peace of mind in the.

Maureen: Check out Evivo probiotics through the link in our show notes

Heather: and enter code milk minute for $10 off. Okay, what a great interview. I hope that’s really

Maureen: helpful for our twin parents expecting twin parents. Please share this with all the twin

Heather: parents, you know. . Yeah. They need all the help they can get. And there’s really not a ton of twin resources.

Maureen: No. And if you guys loved it, let us know and we’ll bring Lindsay back to talk more about this. Yeah. We’re, we’re really excited to finally

Heather: talk about twins. Yes. We were just saying this is our third. National Twin Day. Yes. Right around the corner. Right around the corner in two days since we’ve had the podcast.

And so for two years we kept missing it just because like, like, dang it, poor planning night. This twin day. Oh gosh, Darda, we missed Twin Day again. So it’s been years at the making and we finally got it on time, so you’re welcome. Yay, . All right, well let’s

Maureen: give somebody an.

Heather: Yes. Okay, so today’s award goes to Erin b from Buffalo, New York, and her kiddos, Lucas and Jack.

Erin says, hello. I just heard your podcast on the lifecycle of the breast. I’m 49 years old and I became pregnant after using donor eggs and hubby sperm last year. I had twins in May. I wanted to share that I have been exclusively breastfeeding for almost six months now. I pump three times a day at. At the hospital after I gave birth, the lactation nurses were all over us.

I was unsure if I could breastfeed at all. They were extremely supportive. The comment that made me skeptical but prove true was with the structure of your breast and the visible veins. You should have no problem breastfeeding twins. I love your podcast and listen every week to your new episode. Now I’m going backwards in the history and listening during my pumping time at work.

Thank you for all your research and science-based content. As an RN, I very much appreciate your stuff. I also love your mom and friendship banter. I’m a big fan of the Milk Minute. .

Maureen: Well, thank you Erin. And the award that we are going to give you is the Twofold Moxie Award. Mm-hmm. , because you did it twice as nice.

Heather: You did. And you gotta have a lot of moxie to like trudge ahead after somebody comments on your veiny and gorged breasts, and Absolutely. You know, like, can you just like, Give me some support without commenting on my physical features. , is there any way we could do that? That’d be good.

Maureen: Yeah. Well you did a great job.

And don’t forget, guys, if you want to have an award in the alcove, you can join us on Patreon and submit your wins.

Heather: Yes, and if you wanna see Baby Lucas and Jack, the cute twins from Buffalo, New York, you can check out our Instagram story because you get highlighted if you win the award. .

Maureen: Okay, well, I’m gonna read a quick Apple review before we go.

This one is from Brit Rec and it is titled Angels in Disguise. I have battled mental health issues since before being a mom. I never wanted to take medication for my anxiety. After my second baby, it was very apparent that I needed to take that step because I felt like I was failing as a mom. The episode talking about different medications and how so many women go through this helped me so much.

My life has changed for the better. It’s not a fix all by any means, but the difference it has made mentally is incredible. I feel like a better mom, wife, and I’m actually starting to love my life again. Oh, I might cry. Thank you for letting me know that it’s okay to take that

Heather: step if you need it. I thought you’d like that one.

That’s really cute. That’s why I snuck it in there this morning. So thanks, Heather. It would surprise you. It was surprising.

Maureen: Well, I’m so glad our episode helped you and other people I assume too. That’s

Heather: really wonderful. Yeah, and we’ll put that link to that episode in the show notes. If you are struggling with any mental health issues and you’re curious about medication and breastfeeding, it’s a really good one that will make you feel very, very normal.


Maureen: absolutely. Well, thanks everybody for tuning into another episode of the Milk Minute.

Heather: The way we change this big system that’s not set up for lactating parents is educating ourselves, our friends, and our loved ones. If you

Maureen: wanna show the, show some support you can tell a friend, you can share it on social media or you can join us on Patreon at minute podcast.

And if you could

Heather: write us a little review. Yeah, it makes us happy. Sometimes it makes us cry, but mostly it just supports the show and it lets other people who are looking for a good show to listen to know that we’re a.

Maureen: All right, till next time,


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