Breast Feeding Multiples

Finding out you’re expecting one baby can be overwhelming, but to find out you’re expecting twins, triplets or more can be even extremely overwhelming yet equally as exciting.

You may find it helpful to speak to your midwife, health visitor or local multiple birth association (such as TAMBA or Twins Trust) for guidance and support in the antenatal period.  They will have resources to support you during your stay in hospital and also tips on feeding and support if your babies need to spend time in NNU (Neonatal Unit). 

You may find meeting other parents who already have twins, triplets or more really helpful; finding out what you ‘really’ need to know, such as what equipment you need, what is essential and what is not, do I really need two of everything? 

How you choose to feed your baby is your personal choice: many mothers breastfeed their twins, triplets or more.  You may find it useful to speak to your health professional or infant feeding team to discuss your choices and what will work for you and your family.  During your pregnancy is a good time to think about how you might feed your babies. In addition, it may be helpful to attend antenatal classes specifically for twins and multiples as they normally have a session on breastfeeding and bottle feeding.  There are many options on how to feed your babies: breastfeeding, combination feeding (breastfeeding and bottle feeding either with formula or breastmilk), bottle feeding, or expressing exclusively.

The way you choose to feed your babies may change depending on your experiences during and after birth, such as prematurity, babies being on NNU, babies may be unwell or not putting on weight.  It is important to seek help with feeding if you feel things are getting out of your control.  Around 40% of multiples need some extra help after birth or are admitted to the NNU. 

If this happens you may find that your initial choice of feeding method may need to be altered depending on how they are. Always ask for help with feeding particularly during this sometimes stressful time. In the UK, 8 out of 10 women stop breastfeeding before they want to due to a range of cultural, social and physical barriers. Most hospitals are working towards Baby-Friendly Standards which are designed to ensure that all women receive high standards of care.

Supporting you to build close and loving relationships should be a top priority. All babies should be supported to have skin to skin/Kangaroo Care contact after birth, as this will really help with bonding, experiencing the sensation of closeness, deep relaxation and comfort, temperature control, regulation of heartrate, breathing and feeding in the early hours after birth.

If your babies are born early the team on NNU will help you do this as soon as the babies are able.  You may need help from staff or your partner to help care for your babies, especially when they are both needing to be fed at the same time!

If you have chosen to breastfeed and your babies are very small or born prematurely, you may find it difficult to breastfeed in the beginning. But spending time with your babies, skin to skin contact, and expressing your breastmilk frequently can help with establishing breastfeeding. There is evidence to show that if you start expressing within the first hour after birth it can have a long term positive effect on your milk supply.  The top reasons for why breastmilk is important is that it contains more nutrients needed for a premature baby, and it also provides antibodies that fight infection as well as helping to protect a premature baby’s gut.  Remember that any excess breastmilk can be frozen and used to feed babies in a bottle at a later date.

Tips for feeding multiples

Each baby is a unique little person, they have their personalities right from the start! Each baby will have different needs and face different challenges when it comes to feeding. Ensure you ask for help to observe both babies when breastfeeding. Surround yourself with support, caring for two or more babies is going to take up more time, plus more physical and emotional energy. You need people who will help you and support you so you can learn how to feed your babies.

Don’t rush to get your babies into a routine or a schedule.  Feeding responsively is important to establish a good breast milk supply and if you are bottle feeding not to over feed them.  It can be more critical to respond to your baby if they are born prematurely or small, or not feed effectively to ensure the milk transfer is effective. 

Having a ‘nursing station’ helps a lot! Stocking the areas full of drinks, snacks, pillows (if you need them), book/tablet, nappies, wipes, and extra clothes nearby will always be a help.

If you feel you are not producing enough milk for your babies to be able to breastfeed exclusively, but you wish to combination feed, it is essential that you breastfeed or pump effectively at least 8 times in 24 hours.  Fewer feedings or fewer expressions may lead to a gradual decrease in your milk supply.  Expressing or feeding at night will help keep your supply up due to the prolactin levels being higher at night.

If you are breastfeeding two babies at once try and wait until you are sure at least one of the babies is latching and feeding effectively. Then you can latch the other baby on the other breast. Until you have all met that skill it is better to breastfeed one at a time. I often say there is no rush, learn how to feed one baby at a time (that in itself is a skill), then move onto to tandem feeding (you often need help of another person to pass the other baby to you in the early days).

However much breastfeeding you do, there is no limit on the amount of time you can spend in skin to skin contact or cuddling your babies. Respond to your babies cues for food and comfort will help keep that close bond between you and your babies.

If you are bottle feeding and both babies wake at the same time, it is possible for one adult to feed two babies at once using one of the following positions: position one baby in a baby seat and hold one baby in your lap, holding a bottle in each hand. You could alternate which baby is in your lap at each feed.  You could also feed each baby in an infant seat (for older babies), and you can sit between them both holding a bottle in each hand. Babies should never be propped up with a bottle or left unattended or fed lying down, as this poses a serious risk of choking.

More importantly, be kind to yourself, it is normal to feel overwhelmed when you have more than one new-born, mothers of multiples are more at risk of postnatal depression.  Getting enough sleep is essential, accept offers of help from family and friends, and don’t be afraid to ask for help if you need it. 

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