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Since I am a mom nursing twins and work full time, I very rarely have a chance to get onto CS anymore, but I will let you know what the books don't tell you as far as my experience has been.

Preemies - to get them to go home asap, the hospitals mostly send them home with bottles, very little time BF, and sometimes even on gavage feedings. The only reason that my boys are exclusively BF is because I was EXTREMELY stubborn about wanting to exclusevely BF, and just kept at it. At a certain point I had to not worry about how many CCs they were getting and just trust that they would eat enough and they did. (after 4 months - they were 2 months adjusted age then). No one told me how to transition them, and I was terrified they would not get enough, but after going exclusevely to BF, they actually started gaining weight faster.

You probably will need to accept getting only 5 hours of interrupted sleep at night for 5 months at least. Not easy. This will be your schedule: Wake babies every 3 hours. Change them, nurse them for as long as they will feed, burp them, bottle feed them expressed breast milk (EBM), burp them, pump, try to get them to sleep, get to sleep yourself after setting alarm clock, which will, if you are lucky, be 1.5 hours later. If you work full time like me, in the day time you will basically work in 1.5 hour increments, 6 hours a day 7 days a week. After a couple months, the babies can go longer between feedings, maybe 4 hours, and at 11 lbs or so, they can sleep 6-8 hours at night, but you make up for it by feeding them more in the daytime--nursing every 2 hours instead of every 3. If you work full time like me, you end up having to work during the time they are sleeping nice and long hours at night.

Your babies will probably be smaller (thinner, not necessarily shorter) than formula fed babies, but that is normal. They will likely spit up more than formula fed babies, and this is normal also. 10 ccs of breast milk spit up looks like a cup, so it can be scary to see them loose their lunch all the time, but trust that it looks like more than it really is.

You will probably have some blocked milk ducts... extremely painful--take lecithin 1200 mg 3 X per day. Use hot packs, how showers, massage, and nurse, nurse, nurse, (cry). Blocked ducts are more common in moms of BF twins/triplets.

Take fenugreek to enhance supply.

While babies are in NICU, pump religiuosly every 2.5-4 hours (7-8 times a day) and store the milk. Don't get lazy about it at night or your breasts will overfill, and your supply will go down.

Double BF pillows for the most part, really don't work when you are alone. You can't keep one latched and burp the other one. It may come in handy when the boys get big enough to position themselves and can sit up and such. I am waiting to see about that.

Drink lots and lots of fluids. You will probably be pretty hungry, and will likely not loose a lot of weight right away because your body wants to keep up with the supply. You won't have your period, even if you did when you nursed a singleton.

One of my boys eats 7-8 times in a 24 hour period and the other eats 12-14 times. I spend about 5 hours nursing in a 24 hour period. My boys are 6 months now, 4 months adjusted age. One had heart surgery and is quite a lot smaller than the other, so he eats more often. I can't keep them on the same schedule, although they do synch up often enough that its pretty manageable.

I was led to believe that pumping alone can keep up with their need, but this is not true. At some point, they need to suck to make your body keep up with their demand. All pumping does is empty the breast, which signals for them to fill up again, but the sucking stimulates let down and if they suck longer, the body will get the message to make more milk. At 4 months, I finally quit pumping (unless I have to go into the office for a while) and only BF. At that point, pumping alone wasn't keeping up with their supply and I was using frozen EBM. Now under normal circumstances, I make as much as they need.

The main thing that will make my supply go down is stress. Stress from the pain of a blocked milk duct, not getting enough sleep, not drinking enough fluids, not eating enough, drinking too much caffeine, deadlines at work, and maybe just obsessing and worrying too much. Ocassionally I have to thaw 1 or 2 feedings a day for them if my supply is obviously not keeping up.

I guess these are the basic things no one told me or that were kind of suprising for me.

The main reason I have chosen to BF is for the health of my babies - they have not yet been sick. Also, it is very expensive to buy formula. Finally, I think it is better for my own health to nurse. The main reasons I have thought of to quit are, having more "other" time with the boys. DH is stay at home dad right now, and when he goes back to work, I wonder if I can keep this up. I have made it 1/2 way to 1 year, so I think I can handle 6 more months, especially because they will go onto some solids soon.

Maybe you will disagree with what I said, but it is my own experience. I don't mean to make it seem overly difficult to BF twins, but it is realistically, very difficult to manage the time. It could be different if I was the non-working, SAHM, but I am not. In some ways it helps that DH is SAHD, and I can mostly work from home, but sometimes it is hard to get enough time for work, and I have to use vacation days, so I will have very little time off. No matter to me, it is all worth it...

Do you ever worry about not having enough milk for your twins at a given time? I know overall, I can produce for them, but every so often, it seems one gets shortchanged. I have one fast flow and one slow flow breast. When I pump at work after 4-5 hours, my slow flow gives about 3-4 oz while the fast flow gives 5-7 oz. One of my babies normally gets on the slow flow and the other on the fast flow. Sometimes I put the slow flow baby on the fast flow side to even out how much he is getting. Then I worry there is not enough left in there for the normal fast flow guy. Does that make sense? Anyway, this is when I usually resort to giving one or both some frozen EBM. They normally only take 1 - 2 more oz at most. I just wondered if others had a similar situation.