How to master tandem breastfeeding for twins and multiple babies

Finding out you are expecting two or more babies is a life changing experience and can naturally feel daunting. You may have a lot of questions, and wonder where best to get your answers. Doing your research and learning about breastfeeding and normal infant behaviours before the babies arrive is one of the best ways to prepare yourself.

Breastfeeding any number of babies is a skill which takes time to learn, and twins and multiples come with their own unique set of needs. Surrounding yourself with evidence based information and sources of advice from experienced individuals will help you get off to the best start.

Here we share how to practise tandem breastfeeding for twins and multiple babies including suitable positions and tips for overcoming common challenges.

Understanding the breastfeeding basics

Twins, triplets and multiples behave similarly to singleton newborns - the main challenge for parents is that there is more than one baby to work with. Understanding the behaviours of newborn babies will help set your expectations for how breastfeeding will look in the early days, and also equip you to know when to be concerned and seek additional help and support.

Newborn babies feed frequently - typically every 2-3 hours from the start of a feed - and cluster feeding is a normal newborn behaviour. Normal feeding cues in newborns can be subtle such as their head turning to “root” to the breast, becoming more alert or active, sucking on hands or lip smacking, opening and closing their mouth or bringing their fists to their mouths. Crying is often a late feeding cue. Sleepiness whilst feeding, or prolonged ineffective feeds (typically 40 mins or more) with unsettledness after feeds may be an indicator that further support is required. From 7 days onwards you should expect at least 2 dirty nappies per day and 6 or more wet nappies.

Breastfeeding twins and multiple babies

More often than not twins, triplets and multiples are born early as either late preterm (34-37 weeks) or preterm infants (before 34 weeks) and therefore the importance of breastmilk, whatever amount, is greater.

Babies born before full term (37 weeks) may have additional requirements to help them feed if they are born smaller or lighter. Smaller, sleepier babies can be tricky to feed as they may not display expected feeding cues and so may need additional support to get them started with breastfeeding. Preparing yourself for this possibility will help you adjust and cope.

Colostrum harvesting can be extremely beneficial for your breastfeeding journey as you can build your skills and confidence with hand expressing, whilst building a supply of immunity rich “liquid gold” which is so important for your twins or multiples. Read our guide to colostrum harvesting to learn more.

Milk production

You may be concerned that you will not have enough breastmilk or the ability to feed both your babies - this is certainly the most common worry amongst mothers. However breast milk production is linked to the amount of placental tissue during pregnancy, with those who have more placenta (i.e. twins and multiples) having a greater capacity to produce breast milk.

As with any newborn, initiating skin-to-skin shortly after birth will have beneficial impacts on your milk production alongside frequent, effective feeding. You may hold both or all babies initially at once, however when it comes to feeding, you may want to build your confidence and observe each infant’s ability to feed individually before moving towards tandem nursing.

With multiple babies, one or more babies may need additional support with feeding. A loose schedule or structure to feeding can be beneficial with multiples for both you and the babies, as it can ensure you get enough rest and that all babies get the support they need. There are various ways scheduling of feeds could look - and it is very much based on the babies needs and your own preferences. Get in touch with our team of lactation consultants if you’d like to find out more.

Can I breastfeed two babies at the same time?

Two babies can be breastfed together or separately - it is entirely dependent on what works for you and your family. Initially you may prefer to breastfeed each baby separately whilst you get used to breastfeeding and get to know your babies as individuals to ensure their needs are met, however there are many benefits to tandem feeding and there may be times that you prefer to feed separately or together.

Tandem feeding can of course save time spent feeding, and can be beneficial in building your supply. It can also be an extremely useful strategy if one baby is a less efficient feeder, as having another baby stimulating a let down on the other side ensures more milk is easily available with less effort required.

Positions for breastfeeding multiple babies

Certain upright positions lend themselves well to feeding two babies at the same time. Feeding whilst lying down can be helpful in achieving rest, however is not always the most adaptable for tandem nursing.

Try the below breastfeeding positions for twins or multiple babies:

• Double cradle or cross cradle hold. Hold the babies’ upper backs and loosely support their heads whilst positioning them to latch, whilst their bodies extend around your back.
• Criss-cross. This position works better when an effective latch is established. The babies’ heads rest on your forearms with their bodies extending towards your lap. In a reclined position with pillows to support you, this can work well for younger infants as your body takes the weight and allows unrestricted head movement to achieve a deep effective latch.
• Saddle hold. This position works best for older infants. Your babies are upright facing you in a sitting position.

Tips for breastfeeding twins

• Use a feeding pillow. There are many feeding pillows designed for twins and multiples that may be a useful tool in helping with positioning and can allow you to feed hand free. We recommend waiting until after birth and you’ve practised breastfeeding before purchasing a feeding pillow as there are many shapes and sizes to choose from.
• Ask for support. Your partner, family and friends can help you in any way you need, whether that be with breastfeeding or other practicalities in and around the household whilst you practice feeding. Don’t be afraid to involve your support network in any antenatal classes and education you receive too.
• ** Seek professional advice.** Lactation consultants can help to prepare you for breastfeeding twins or multiple babies as well as helping you after birth. This can include any specific areas you need support with such as latching, positions, milk flow and reaching your breastfeeding goals.

What to do if one baby doesn’t take

There is more than one way to do everything and knowing your options can help make a practical plan that works best for your family. If you are unable to breastfeed one or more of your babies at the start of your journey, you can still go on to breastfeed successfully if given the right support.

Breast milk can be given directly from the breast, or as expressed milk, and it is important to know any volume of breast milk will be of benefit to your babies. If you do run into difficulties with feeding your babies, make sure to seek support from healthcare professionals experienced in supporting families with twins or multiples.

Many mothers who have breastfed twins or multiples report many benefits, especially in relation to bonding, rest and once breastfeeding is established, it does not take more time than bottle feeding and it is overall easier. While breastfeeding two or more babies requires a bit more time and organisation than one, it is completely achievable!

If you’d like help with breastfeeding twins or multiple babies, get in touch with our team of experts. Our friendly breastfeeding consultants are fully certified as IBCLCs and can provide 1-2-1 support on any concerns you may have. Speak to a lactation consultant at a time that suits you today.