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Feeding twins and multiples - NHS

Feeding will take up a lot of your time in the first few months of your babies' lives.

Whether you breastfeed or formula feed, you'll need to create a routine that suits you and your babies.

Some mothers can feed 2 babies at the same time, while some prefer to feed 1 after the other.

Others feed whenever their babies seem hungry (on demand).

If 1 baby is smaller and needs to feed more often, you will not be able to feed them at the same time at first.

If you want, you can work towards bringing their feeding routines together as your babies grow.

If you have any concerns about your babies' growth, you can take them to your local baby clinic to have them weighed and measured.

Your health visitor can tell you where to find your nearest baby clinic.

Some health visitors will visit you regularly at home to keep an eye on your babies' progress.

Breastfeeding twins or more

It's important not to be put off breastfeeding because you're having more than 1 baby.

Breastfeeding is a great way to soothe your babies and helps you build a strong bond with them.

It's perfectly possible to breastfeed twins, triplets or more. Lots of twins are breastfed until they start eating solid foods.

You may like to try a few breastfeeding positions to see which suits you best.

You'll get support with breastfeeding at the hospital and also when you take your babies home.

The benefits of breast milk for your babies are the same as for single babies.

But as multiple babies are more likely to be born prematurely, there are extra benefits.

Breastfeeding premature twins

Breast milk is better for premature babies as their gut is immature and it's easier for them to tolerate and digest.

Breast milk also contains proteins and antibodies to protect your babies against infections.

If your babies are very tiny or sick when they're born, you may need to express your breast milk to begin with.

Your expressed milk may be fed to your babies through a thin tube that passes through the nose and into the stomach. 

Visit the Twins Trust website for more information on breastfeeding twins or more.

Watch videos of mums talking about breastfeeding more than 1 baby

Formula feeding multiples

You may need to combine formula feeding with breastfeeding if, for example, you have triplets or more, or you may choose to only formula feed your babies.

Formula feeding is more expensive than breastfeeding when you have twins or more.

But it does mean that other people can help with feeding your babies.

As with breastfeeding, you'll need to decide whether you're going to feed your babies together or separately.

Bottles need to be freshly prepared for each feed. This can be quite time consuming with twins or more, so you may want to ask your partner or someone else to help with this.

As with breastfeeding, formula feeding your babies can help you build a close and loving bond.

Hold your babies close during feeds, look into their eyes and talk to them.

Learn to notice their cues when they want to be fed and when they have had enough.

Visit the Twins Trust website for more information on formula feeding twins or more.

Weaning twins on to solids

When your babies are around 6 months old, you can give them their first solid foods.

It's not unusual for 1 baby to be ready to begin solids before the other.

Find out more about your baby's first solid foods

If your babies were born prematurely, your health visitor can give you advice on the best time to start solids.

Unless 1 of your babies has a serious infection, it's safe for them to share spoons and bowls.

Visit the Multiple Births Foundation website for more advice on all aspects of feeding twins, triplets or more (PDF, 5.96kb).

Video: breastfeeding twins

In this video, a breastfeeding support specialist gives advice on how to breastfeed twins.

Media last reviewed: 1 September 2021
Media review due: 1 September 2024

Page last reviewed: 12 August 2019
Next review due: 12 August 2022

Breastfeeding twins and triplets

Being a mother of twins or triplets is a great joy, but at the same time a challenge, especially in terms of breastfeeding. However, with proper support, breastfeeding twins is quite possible. Read more about this in our article.

Share this information

When you are expecting several babies, there are many things to think about, feeding is the first thing. Organizing breastfeeding for twins or even triplets is a very difficult task. But be sure: it is possible, and the result will justify itself doubly.

Like any breastfeeding mother, you need to understand the basic principles of breastfeeding: how milk production depends on consumption, how to find the right position and help babies latch on.

Additional difficulties in breastfeeding multiple babies are associated with time (more precisely, its absence), maintaining the mother's physical strength and finding the optimal feeding pattern. Solving these problems will be easier with someone's support.

How to prepare for breastfeeding twins?

The main thing is to start preparing before the birth. Even if you've breastfed before, talk to an expert about feeding twins.

You can attend special courses for pregnant women, and a lactation consultant or supervising physician can teach you the basic principles of twin care and answer any questions. In addition, it will be useful to talk to mothers of twins and find information about small and large communities dedicated to raising twins. These communities often host meetings, publish helpful articles, provide phone support, and offer other types of assistance.

Arrange in advance with relatives and friends to help around the house, ask them to take over cooking, cleaning and shopping responsibilities so that you can fully devote yourself to breastfeeding. Robin, a mother of four from Canada, says this is extremely important: “For the first two months, my mother-in-law lived with us. I can’t imagine what I would do without her!”

In addition, it is important to correctly understand what awaits you. You will have to learn how to breastfeed two children at the same time, you will not sleep much, and at first you will not have time to leave the house at all.

“Life is going to be pretty stressful at first: get ready to dedicate all your time to breastfeeding,” warns Helen Tourier, head of support at the British Twins and Triplets Care Association (Tamba), a professional nurse and mother of three children, including twins. Feeding may take longer, especially if the babies have spent some time in the neonatal intensive care unit.

How to start breastfeeding twins?

The best way to start breastfeeding successfully is to ensure skin-to-skin contact with babies as soon as possible after delivery. ¹ Include this item in your birth plan and discuss your intention to breastfeed with your partner and healthcare providers ahead of time. Consider what to do if babies are born prematurely or are admitted to the neonatal intensive care unit.

Ideally, breastfeeding should begin immediately after delivery, even after a caesarean section. Doctors should bring you babies and teach you how to properly attach them to the breast. If they haven't, ask for it and be sure to involve your partner so they know how to help you.

“I think the main reason I was able to successfully breastfeed my twins, having previously struggled with feeding my eldest son, was the help from the maternity hospital experts during those critical early days,” says Zoe, mother of three from Great Britain.

Will I have enough milk for two babies?

Yes. The more babies you feed, the more milk is produced. Research shows mothers of triplets can produce three liters of milk a day0029 2 , despite the fact that the average baby boy needs 831 ml of milk per day. ³

After you give birth, you will begin to produce enough colostrum (nutrient-rich first milk) to feed newborn babies for the first two to four days. After that, the production of milk will take place on the principle of supply and demand.

Focus on the needs of the little ones. Breastfeed as soon as you notice any signs of hunger in any of them - babies may begin to wake up, stick out their tongue, turn their heads, grunt, lick their lips, suck their fingers. This will help your body produce enough milk.

How to make breastfeeding twins easier?

You and your little ones will have to learn by trial and error. One baby may latch on better, eat more often, or gain weight faster than another. Remember that every baby is unique. If you have any difficulties or doubts, contact a specialist.

“An obstetrician I know helped me for a long time to find the right position so that the babies would latch on correctly, — one of my daughters had problems with this at first,” says Anna, a mother of two children from the UK, “In the first month, I really needed help during feeding - at least in order to give me babies. It's hard to handle two babies at the same time, especially when they're so small."

Remember, the first weeks are the hardest. Feeding will not always be such a long and tiring process. And don't forget that breast milk, in any quantity, brings enormous health benefits to your babies.

If you're not sure you can make do with breastfeeding alone, or babies aren't gaining enough weight on breastmilk, discuss feeding options with your healthcare provider, lactation consultant or healthcare provider, and your partner to make the best decision together for your family.

Comfort and proper attachment to the breast is the key to successful feeding. Use a special breastfeeding pillow to find the optimal position and relieve stress on your wrists, arms, shoulders and back.

Although all your energy and attention will be devoted to babies, do not neglect your own nutrition and health.

Bethan, a British mother of two, advises: “Try to get as much sleep as possible. Order groceries online and schedule delivery when family or friends are home. Prepare a large bottle of water and drink at every feeding. Ask relatives to take the children away after feeding so that you can rest.

What if babies cannot suckle?

If one or both babies need to be hospitalized or were born prematurely, breastfeeding is still possible but will have to wait. If babies cannot latch on, you can express milk for them. So you can start and establish the production of milk, and your babies will receive all the useful substances that it contains. Your healthcare provider will help you learn how to feed with a syringe, tube, or other method. It is necessary to express milk according to the breastfeeding schedule - every two to three hours for about the first month. ⁴

“I had a C-section at 30 weeks and my twin girls spent a few weeks in the neonatal intensive care unit,” recalls Monika, mother of three from Switzerland, “We were only able to start breastfeeding at 34 weeks. 35 weeks. So for the first month, I pumped milk every day—at least eight times a day. I felt that this was the most important thing I could do for them.”

One of your babies may be strong enough to breastfeed on his own, while the other needs expressed milk. In this situation, many mothers prefer to express milk for a weak baby at the same time as feeding a strong one.

Breast milk has been shown to reduce the risk of developing serious diseases that preterm infants are more susceptible to, including necrotizing enterocolitis and sepsis. ⁵ So if your babies are getting even a little expressed breast milk, you know that you have created the best conditions for them.

How to feed twins: together or separately?

Each option has its own advantages. Until you get comfortable, it is worth feeding the babies separately, and then switch to pair feeding to save time.

There are many positions for breastfeeding twins, such as under the arm (one baby under one arm, the other under the other), parallel (both babies lie across the mother's body with their heads in the same direction) or lying down (both babies lie on the mother's stomach) . Ask a lactation consultant or supervising doctor to show you these poses. Perhaps you will like one of them or you will use different poses in different situations.

“It was easier for me to feed my twins at the same time,” says Zoe, a mother of three from the UK, “I also fed both at night at night. If one woke up for feeding, the husband woke up the second.

It may be more convenient for you to feed the babies separately when they ask, or to wake the second one after feeding the first one. And you can combine all three options.

Breastfeeding two babies at the same time in public is not easy, but for this case you can buy special capes so as not to be embarrassed.

“However, pair feeding of two babies is not for everyone. It happens that when one takes a breast, the second one throws, - says Robin, a mother of four children from Canada, - It just drove me crazy. It ended up that I began to feed in turn. Yes, it took more time, but I was calm.”

Some mothers assign each baby a specific breast and feed from that breast all the time. But it is much more useful to rotate the mammary glands in case one produces more milk than the other. Such a problem may arise in the early days, especially if one of the babies is weaker. In rotation, the stronger baby will stimulate the weaker baby to produce milk, so that sooner or later both breasts will produce the same amount of milk.

Breastfeeding multiple babies is very difficult for me. What to do?

Don't be afraid to ask your loved ones to take care of you so that you can take care of your little ones. "Sometimes coping means not taking on what you can't handle," says Bethan, a UK mom of two.

Seek psychological support and expert help at any stage of breastfeeding.

“I lost my composure at the sixth week,” recalls Billy, a mother of four from the UK, “I called the hotline and went to the breastfeeding support group, where I was advised on more comfortable positions. I don't regret it at all."

Most importantly, don't blame yourself if something doesn't work out for you. Breastfeeding multiple babies can sometimes seem like a daunting task.

“Breastfeeding one baby takes a lot longer than you might think. The main thing is to stay calm, - says Olivia, mother of four children from Australia, - And it takes much more patience to feed two children. But the result is worth it."

Literature

1 Crenshaw JT. Healthy birth practice# 6: Keep mother and baby together - it's best for mother, baby, and breastfeeding. J Perinat Educ . 2014;23(4):211. — Crenshaw, JT, "Physiological Birthing Practices #6: Mother and Baby Should Be Together - Better for Mother, Baby, and Breastfeeding." J Perinat Eduk (Perinatal education). 2014;23(4):211.

2 Flidel - Rimon O , Breastfeeding twins and high multiples.Arch Dis Child Fetal Neonatal Edn. 2006;91(5):F377-F380. — Fidel-Raymond O., Shinwell I.S., "Breastfeeding Twins, Triplets, etc." Arch Dis Child Fetal Neonatal Edn. 2006;91(5):F377-F380.

3 Kent JC et al. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3):e387-395.- Kent JS et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics). 2006;117(3): e 387-95.

4 Kent JC Principles for maintaining or increasing breast milk production. J Obstet Gynecol Neonatal Nurs . 2012;41(1):114-121. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". G Obstet Ginecol Neoneutal Nurs. 2012;41(1):114-121.

5 Underwood MA. Human milk for the premature infant. Pediatr Clin North Am . 2013;60(1):189-207. - Underwood M.A., "Breast milk for the premature baby". Pediatrician Clean North Am. 2013;60(1):189-207.

Feeding twins and triplets: how to organize the process

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November 27, 2020

The birth of a child is both a joyful and exciting event. If young parents are planning the appearance of twins or triplets, then the scale of expectation grows many times. Quite often, future parents think that there is not enough breast milk for all the babies, and they begin to plan what mixture they will use after childbirth. Fortunately, such thoughts are erroneous, with the right approach and attitude, breastfeeding will be the key to good health for babies and peace of mind for mothers.

Is there enough milk

Immediately after childbirth, the process of producing colostrum occurs, it will be enough to feed two babies for 2-4 days. Further, the amount of milk will depend on the frequency of feeding babies. The more often you feed your babies, the more milk will be produced. At first, newborns need to be fed only on demand so that the mother's body understands how much milk is needed for children and can produce the right portions. If the children are not always with their mother, she will need to express milk all the time in order to establish the correct lactation process and not lose it. Then it is better to switch to breastfeeding twins according to a certain regimen - this will help organize the daily routine and it will be much easier for mom.

Organization of the feeding process

Babies are not born with the ability to breastfeed, but they learn how to do it right very quickly. It is important to start putting babies to the breast as early as possible, preferably from the first hours of life. At the hospital, nurses or breastfeeding consultants will help you breastfeed your babies. At home for the first time, until you get used to doing it yourself - you will need the help of a husband, relatives or girlfriends. You just need to remember that if one baby asks to eat, you need to attach both to the chest. First attach more impatient, and the second after him.

And how to attach three?

When feeding three, you will need a helper to help you with the third baby while you are feeding two. Attach two children for ten minutes to two breasts, and then the third to each for five minutes. Change babies at the next feeding. If you are afraid of getting confused, keep a feeding diary. Write down who, when and how much ate. It is difficult for triplets to fully organize breastfeeding only, so they are most often on mixed feeding. However, if you want to maintain full lactation, it is necessary not to use bottles for supplementary feeding with formula - they spoil the attachment to the breast and lead to refusal of it.

Feeding positions

You can feed two babies at once sitting, lying down or on your stomach. One of the most comfortable postures is considered to be the “from under the arm” position. It is very good for her to use a donut pillow for feeding. The babies are located on the sides of the mother, turn their tummy to the sides, legs behind her back.

You can place one baby in the “cradle” position, and place the second to the other breast “from under the arm”.

"Double cradle" - this is one baby lying in her arms, pressing her tummy against her mother's stomach, and the second is located behind him, nestling against his back, and is applied to the other breast. Most likely, mom will need pillows or rollers to support her arms and babies.

“Pose on the back” is the mother, leaning back on the pillows, reclining, and the babies are applied to the chest, located on the mother’s shoulders, forearms and stomach in the shape of the Latin letter V. The mother holds them with her hands, leaning on the pillows to her side. So many mothers feed their children at night.

The “on the stomach” position is not very common, usually the mother is lying on her stomach (you can lie on a pillow), leaning on her elbows.

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