Breastfeeding Twins or Multiples

By Dr Ananya Mandal, MD

Feeding twins, triplets or more is special but may be a challenge. It is vital that the mother is educated regarding the benefits of breastfeeding her babies.

Twins and triplets may often be preterm and low birth weight. They may have had a difficult delivery as well. This makes breast milk more beneficial for them to catch up on their growth and development.

Most mothers may feel overwhelmed at the idea of feeding two babies at once. The challenge is particularly greater for young or teenage mothers and those mothers who wish to rejoin work after their maternity leave.

Tips for breastfeeding twins or multiples

Some tips to make breastfeeding twins or multiples work include:-

  • Planning ahead. A breastfeeding class, confidence on ability to feed the babies as well as commitment to the practice of exclusive breastfeeding for at least 6 months helps. A common fear that there may not be enough milk for both babies should be laid to rest. The body makes milk for two or more babies in a mother of twins of multiples. Many mothers fully breastfeed or provide milk for triplets or quadruplets.

  • Adequate familial and partner support. At least the initial few weeks when the mother as well as the babies is learning to breastfeed can be a challenge. Partner and familial support as well as guidance from a lactation consultant help. This is more important in case of small, preterm or low birth weight babies.

  • Twins or multiples are more at risk of ailments of the newborn like jaundice and difficulty in feeding including poor suck. They may also need to stay in the NICU (neonatal intensive care unit) for care. These babies can still be breastfed with some adjustments.

  • For adequate milk coming in after birth, breastfeeding should be started as soon as possible after delivery. The more milk that is taken from the breasts, the more they make especially during early days. If the babies are born preterm or before their time, the mothers may be encouraged to express breast milk. This helps them make more milk. In addition mothers who intend to breastfeed their multiples need to have a healthy balanced diet, including 3 balanced meals and 2 snacks. They need to drink plenty of water to stay hydrated and rest at least once a day.

  • Regular weight checks. The twins or multiples need to be checked regularly from adequate weight gain and growth to see if their feeding is correct. A regular count of wet diapers also helps keep count of adequacy of feeding.

  • To ensure that both babies get fed, mothers can “assign” a breast to each baby for a feeding and switch at the next feeding. This switching helps to keep milk production up if one baby has a poor suck compared to the other.

  • Breastfeeding positions vary for twins and triplets especially if not done “one at a time”. Most mothers prefer the latter approach and their preferred positions are similar to singleton pregnancies. Some of the positions for twin babies include the double clutch (football hold), a cradle clutch combination or a double cradle position.

  • When both babies are hungry at the same time and “one at a time” formula does not work, mothers can opt for certain measures. This includes feed the more hungry and awake baby first or distract the other baby while feeding one. If this fails both babies can be fed at once. For distraction the baby can be given a pacifier (not recommended for babies under 6 weeks of age before breastfeeding is completely established), placing the baby in a swing, cradle or stroller, asking someone to hold and calm the baby etc.

  • Full and complete breastfeeding is ideal for twins and multiples as well as single babies. However, some mothers may choose to supplement feeds with some formula by bottles at times.

Reviewed by April Cashin-Garbutt, BA Hons (Cantab)

Sources

  1. http://whqlibdoc.who.int/publications/9241561300.pdf
  2. http://www.womenshealth.gov/publications/our-publications/breastfeeding-guide/breastfeedingguide-general-english.pdf
  3. http://www.breastfeedingbasics.org/pi/pi-147.pdf
  4. http://www.stjoes.ca/media/PatientED/A-E/BreastfeedTwinsTriplets-lw.pdf
  5. http://www.beststart.org/resources/breastfeeding/pdf/breastfeeding_matters_eng_fnl.pdf

Further Reading

Last Updated: Feb 28, 2013

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