Breastfeeding Twins

Many mothers-to-be that know they are going to have twins often question whether they will be able to breastfeed exclusively, with milk supply and demand feeding (now referred to as responsive feeding by health professionals) common concerns. Here I have offered some key advice on the most frequently asked questions when it comes to breastfeeding twins:

Can I breastfeed exclusively with twins?

Yes – you can breastfeed exclusively. What you first need to do is believe in the amazing ability of your body to meet the needs of your babies. Your role in the early weeks after birth is to nurse frequently so that you get your milk supply established, look after yourself with a healthy diet and sleep when you can, this will give you a great foundation. Your breasts are given the blueprint for milk production in the first 7 days after birth and your body can make enough milk for one baby, twins or triplets with the right programming.

What if my babies arrive early?

Often you may be advised that you won’t carry your babies to full term and occasionally they are born early in which case they will need a little help. Your milk will help your babies to catch up on the growth that they missed out on, giving them antibodies to keep them healthy, protect their delicate guts, top up on essential fatty acids to help their nervous systems and eyes, as well as tailored milk that is specific to help preterm babies grow.

If your babies do come early the neonatal unit nurses and delivery room midwives will help you to establish your milk supply by early expressing – ideally within the first hour after birth with hand expressing and using a hospital grade breast pump. You do need to express around 8-10 times in every 24 hours if your babies are unable to nurse so that you initiate milk production and maximise volume. Lots of skin to skin cuddles helps you to boost those milk producing hormones and keep babies warm, as well as this your natural bio flora helps to protect them and most importantly lots of skin to skin helps you to bond with your little ones.

Latching on and Feeding Positions

Preparing to breastfeed can be a daunting task – do I feed both at the same time? Do I feed one then the other? There is no one answer it is just a case of trial and error to see what suits you as a family.

From a time point of view feeding both together is the ideal but this can take a lot of practice especially in the early weeks. A great tip is to use a v shaped pillow – these are bigger than the breastfeeding pillows so that you can lay your babies on them and be fairly hands free to help with latching on. Of course if you prefer to feed one and then the other this is fine too.

A great position for tandem feeding is the under arm (rugby hold) this helps you to latch little ones on and see, and support the other at the same time.

If they slip off and you are getting sore ask your midwife to sit with you whist you feed so that you can tweak a little on the positioning, helping to get that lovely big wide mouth. If staying on is still a little challenging using a nipple shield may help sustain a latch and keep baby sucking. It may only be a short term plan until they grow a little and improve tone to latch with less assistance.

When sitting make sure that the babies’ noses are at the same level as your nipples – nipple to nose, chin to breast. If they are higher your pillow is raising them too much and you will find that you will be more uncomfortable. If they are a little early they may need a little help with staying latched on and feeding. Listen out for lots of swallowing of milk, a good deep and comfortable latch will help this. As they grow you may find that you need to be flexible and the usual positions don’t work. Many mothers of multiples say that their babies often find their own position and do a little position gymnastics.

Alternate each baby’s breast so that both breasts are emptied effectively and that your babies don’t get a preferred ‘boob’. You may have one baby who feeds better than the other, or one breast that has more milk, this is normal. 

Expressing and Getting your Partner Involved

If you want your partner to help out with feeds you may want to express – a double electric breast pump is the ideal solution as not only is it time effective with expressing both at the same time but it also triggers an additional milk ejection reflex giving you more milk compared to single pumping.

Finding the time to express can be a little daunting but it’s good to know that around 45 – 60 mins after the last feed your breasts will have refilled so you could sneak a pumping power session in before the next feeds. You may choose to express whilst you feed one baby as another option. What is reassuring is the more milk you remove from the breast, the more milk you make.

Using the Calma Feeding device to give your breastmilk will support your baby to move smoothly between breast and bottle as it enables baby to use their natural sucking behaviour learned at the breast, allowing an easier transition.

Combination Feeding

If you choose to mix feed with formula and want to give primarily your milk, ideally wait until your breastmilk production is established before introducing formula. Continue to remove your milk by feeding or expressing every few hours to maintain your supply. Formula is different to human milk and may result in your babies being more fussy as it takes more effort to digest, it is not as bio available as your milk and doesn’t have the fabulous health, immunological and developmental benefits. It is fine to compliment if this is your choice – it’s making an informed decision for your babies and your family.

Top Tips

  • A warm chain of support, encouragement, evidence based advice and information is vital and remember to always ask for help if you need it.
  • Be realistic in your goals, take each feed and each day at a time.
  • The more of your milk you can give to your babies the greater the benefit for you as well as them.
  • You are an amazing mum, with an amazing body making more than one baby, and breastfeeding will help your babies now and later in life to become healthy infants, children and adults. Every drop counts – human milk is an incredible gift that you can give.