nursing twins

The following links will take you directly to a topic paragraph. Read on for a comprehensive overview of the ins and outs of nursing twins.

Nursing twins is possible. Although nursing two babies may take a little more patience, planning and perseverance, most women who have nursed their twins say it is worth any extra effort. Breasts are designed to produce as much milk as needed, so nursing twins is as normal as nursing one infant.

why nurse twins?

Nursing provides the babies with all the important antibodies and immunities found in a mother's milk. This can be especially beneficial for twins, who are often born prematurely. If the twins are premature, the mother's milk will be higher in amino acids and proteins than the milk of a mother of a full-term baby. This richer milk helps the babies gain weight quickly. Although having premature twins can be a stressful experience, providing breastmilk for her twins while they are in the hospital can be a positive experience for the mother and provide her with a feeling of doing the best for her babies (see the Nursing Mothers Counsel brochure on "Maintaining a Milk Supply for the Premature or Ill Infant" for further information).

advantages of nursing twins

Most women find that nursing twins is easier than formula feeding. Nursing saves time and money. Tandem nursing (where babies are nursed simultaneously, one on each breast) solves the problem of who to feed first if both babies are hungry at the same time. Tandem nursing increases milk production more quickly since more milk is removed at the same time. Preparing formula and sterilizing bottles for two babies takes a lot of time. Nursing provides a relaxing time for the mother to sit down, relax, and get to know her babies.

getting started

nutrition A mother who is nursing twins needs extra rest, extra nourishing foods, extra liquids and perhaps extra pre-natal/lactating vitamins. Nursing twins requires more daily calories than being pregnant with twins. Nutritionists recommend that women nursing twins eat 3,000 calories daily. This is not the time to diet! Most women find they can eat lots of nourishing food and still gradually lose their pregnancy weight because of the calories expended by nursing two babies. Many doctors recommend that mothers who are nursing twins not try to return to their pre-pregnancy weight until the twins are at least six months old.

sore nipples A mother who is nursing twins must be particularly careful about preventing sore nipples. A mother who is positioning her babies correctly on the breast in the beginning will avoid sore and cracked nipples. It is important to change nursing positions, air-dry nipples after nursing and also to maintain a good diet and get lots of rest. She needs to be extra careful that her babies are latched on properly in a good nursing position. (See the Nursing Mothers Counsel brochure on "Proper Positioning" for further information).

household help If possible, mothers of twins would benefit from some household help in the early weeks, especially if there is a toddler or other children in the house. It is unlikely that a new mother of twins will be able to do more than nurse her babies and take care of herself in the first few weeks. She should not hesitate to ask for specific household help, such as, "Here's my shopping list, laundry to fold, etc." Although it may be difficult, if there are older children it is important she also schedule some individual time with them during those busy first few weeks. She should rely on family, friends, or hired help to take care of housecleaning, meal preparation or taking older children on outings. Fathers can be quite helpful in the early days by changing diapers, bringing the babies to the mother to feed, and burping and rocking the babies. A father's support, assistance, and patience are extremely important for successful breastfeeding of twins.

outside support A pediatrician who is supportive and knowledgeable of nursing twins is also quite important. New mothers should interview pediatricians before her twins are born, and she should select a pediatrician who supports her breastfeeding goals. She should talk to other mothers of twins or even join a local Mothers-of-Twins club to help her find support from the medical community. There are also publications available about caring for twins.

tandem nursing positions

Breastfeeding twins simultaneously is a real time-saver, but many mothers find it awkward in the beginning, especially if the twins are premature and have little neck control. As the twins become stronger and the mother more confident, tandem nursing (where babies are nursed simultaneously, one on each breast) becomes easier. If the twins are full-term and healthy, it is a good idea to practice tandem nursing at least once a day, so both the mother and the twins become comfortable with it. In the beginning, the mother will need help getting the twins positioned. It may be easier to position the less vigorous nurser first, then put the more vigorous nurser to the breast. New mothers should experiment with different positions to see which is the most comfortable. The two nursing positions which work well for tandem nursing are the double clutch or "football hold" and the cradle/clutch.

the double clutch or "football hold" The mother has each baby tucked under an arm in the football hold. The mother is seated comfortably on a couch, bed or even the floor with lots of pillows or blankets under the babies so she does not have to hold their weight or lean into them. Some Mothers-of-Twins clubs will loan a "U" shaped pillow, designed for nursing twins in this position. (See figure 1)

cradle/clutch hold One baby is in the cradle breastfeeding position and the second is in the football hold. This way each baby can have equal exposure to left and right visual stimulation (which comes from looking up at the mother's face), even if they have favorite sides to nurse from. The mom can simply alternate cradle and clutch positions. (See figure 2)

Mothers should feel free to experiment until they find a position that works for them. As long as each baby is well positioned on the breast and they each receive equal visual stimulation, any position is acceptable.

individual nursing

Tandem nursing does require more of the breast to be exposed and is difficult to do discreetly. Mothers should not hesitate to ask visitors to leave the room if they are uncomfortable tandem nursing in front of others. When out in public, she may want to nurse her twins separately since it is more discreet.

Some women prefer to breastfeed each twin individually. While this is more time consuming, some mothers feel they need time with each twin to aid with the individual attachment process. Other mothers feel that time alone can be given in other activities and breastfeed individually only occasionally. Mothers who tandem nurse need to take into account the differences in their twins' nursing styles. One may be a vigorous, fast nurser while one may be a slow, un-hurried nurser. Therefore nursing times may not be the same for each baby, even when they are nursing together.

helpful tips

which breast is whose? There are many ways in which mothers breastfeed twins. Some women prefer to assign a breast to each infant and always nurse the twin on that breast. More and more women seem to be more comfortable switching breasts at each feeding. For example: Twin A nurses on the left breast at one feeding, then nurses on the right breast at the next feeding. Switching at each feeding will even out the milk supply if one twin is a more vigorous sucker and will provide each twin with equal visual stimulation.

demand or schedule? Although the babies should be fed on demand when possible, twins may need to be awakened and nursed more frequently if they were small at birth. Nursing every one to two hours is not too frequent for newborn twins. A little manipulation of feeding times may be necessary for the mother's needs, especially if she is tandem nursing. A more rigid schedule may even be necessary for a mom with older children to take care of. Even if she is nursing separately, she may still want to awaken the sleeping twin and nurse him or her after nursing the first one. This will allow the mother to get the maximum amount of rest between feedings.

relief bottles Relief bottles can be given, but preferably after six to eight weeks, to ensure a plentiful milk supply and establishment of the breastfeeding routine. In the early weeks it is important that the breasts are frequently stimulated by the babies' sucking so that the supply remains adequate. Many mothers of twins collect milk while breastfeeding one baby, by placing a clean bottle or cup under the free breast. Mothers of twins need to avoid using too many relief bottles, since babies can start preferring the bottle over the breast, which can lead to breastfeeding difficulties. Giving too many bottles can also lead to plugged ducts and breast infections because the breast is not being emptied regularly.

Having and nursing twins can be a wonderful, fulfilling experience. Mothers are encouraged to relax and enjoy this special time in their lives.

further reading

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This brochure has been approved by the following members of the N.M.C. Medical Advisory Board: Stephen J. Buchner, M.D., Kenneth Castor, Jr., M.D., James A. Cisco, M.D., Arthur S. Dover, M.D., Donald B. Lathrop, M.D. Frederick A Lloyd, M.D., and Jane Phillips, M.D.