Where to begin when breastfeeding multiples

This article first appeared in the February/March 2016 issue of Your Pregnancy magazine.   

1. Where to start

To breastfeed your multiples, it all starts with your emotional state and a willingness to succeed, says mother of twins and South African Multiple Birth Association (SAMBA) lecturer, Erika Smuts.

“You have to get your mindset right. Your mind is the most important breastfeeding organ, because when you’ve made up your mind, it’s so much easier to find ways and means, to find help, and be kind to yourself,” she says.

Accept that your lifestyle is going to change if you choose to breastfeed, and that you’ll need plenty of support, both emotionally and practically, in the first few months.

“When you breastfeed one baby, it’s quite challenging, but when you breastfeed two, it’s twice as challenging. Support is really the key at home, because you’ll be very busy with breastfeeding,” says La Leche League group leader and mother of twins Vania Truter. “If you can afford home help, then you must have it,” she advises.

• Also see: Everything about breastfeeding 

2. Plan ahead and accept help

Be sure to let your doctor and the nursing sisters at the hospital know about your decision, so that they can offer support. If you’re able to get to full term (36 weeks with multiples) and have an uncomplicated birth, latching soon after the birth will really help your chances of successfully breastfeeding, says Vania, who feels this was a crucial part of her success with breastfeeding. 

Forward planning about practical details is also key. Make sure your freezer is well stocked with nutritious meals so that you can eat well and maintain your nutrition. Another important preparation is to find people who will support you while you settle into the challenging role of breastfeeding your multiples.

It may be someone who can help with housework, a nanny, night nurse, your husband or supportive relatives – as long as it’s someone who understands they’re there in a supporting role. “Accept whatever help is offered that you’re agreeable with, particularly in the beginning, when you might feel quite overwhelmed,” advises Erika.

• Also see: Breastfeeding? What to eat and not to eat

3. It takes time

Moms of multiples understandably worry about whether they can produce enough milk for two. “Rule number one is that the more you express or feed, the more milk your body will make. The more you feed your babies formula, the more you will find that your body produces less milk – and you run the risk of nipple confusion,” cautions Smuts. She clarifies that sleeping through one feed while someone else feeds your multiples is unlikely to slow your milk production, but that skipping three or four feeds a day will affect it detrimentally.

“Have realistic expectations about the time that it takes to breastfeed multiples and to establish a breastfeeding routine,” says Erika. “It takes about six weeks for your milk supply to stabilise. At around six weeks old, the babies have a growth spurt and it may feel that you don’t have enough milk, and this is when many mothers get despondent, but if you feed more frequently, you’ll get through that,” she says.

It also takes at least six weeks to get the hang of latching and which positions are more comfortable for you. 

• Also see: Overcoming common breastfeeding problems

4. Call in the experts

Now is not the time to go it alone – when you’re breastfeeding multiples, a good latch for all the babies is essential to avoid any other problems like cracked nipples.

A breastfeeding consultant will help you to latch successfully and will help you learn to latch both babies at the same time. “It’s very important to meet your lactation consultant before the birth, to assess whether you feel relaxed with her – this person will be helping you with a very intimate, personal process and you need to be able to work with her in a way that you are comfortable with,” advises Smuts.

“A [breastfeeding] support group in your area can really help you,” advises Vania, who recommends visiting the group before the birth to familiarise yourself. 

• Also see: Mom shares powerful post on the pains of breastfeeding 

5. Position, position, position

Most moms of multiples in South Africa are likely to have a caesarean birth, and with a tender incision, the first feed might be easiest lying prone on your side, in which case you’ll begin by feeding your multiples one by one.

However, going forward, “It’s preferable to feed both at once, because it saves time,” recommends Smuts. However, cautions Vania, tandem feeding doesn’t work for every mom – some, for practical reasons, may choose to feed one at a time, particularly if you don’t have a lot of help at home and literally don’t have a spare pair of hands to pass you the second baby once the first one is latched. 

“The most common hold is the ‘rugby hold’, with each baby under an arm with their legs facing towards your back,” says Smuts. Other options include feeding both conventionally, with their legs across each other, supported by pillows.

Alternatively, try lying back in a prone position with your back well-supported and both babies lying on your stomach with their legs towards your feet. If you’re using a feeding pillow or cushion, make sure it holds your babies parallel with the breast – if not, you’ll increase your chances of chafed or raw nipples, she advises.

There are special feeding pillows for multiples available locally. 

If you’re feeding triplets, you’ll need a slightly different strategy. What you’re likely to do is feed Baby 1 on breast A, Baby 2 on breast B and Baby 3 on those two breasts after the other two have fed. The next time you feed, you’ll start with Baby 3 on breast A, explains Smuts. 

• Also see: FAQs about breastfeeding and working mothers  

Top tips from moms of multiples

Amor Herbst, mother of twins, says, “The biggest key factors are information and support – having the right information, knowing that your body will make the milk you need, and getting motivation and encouragement. I found the La Leche League was a very solid resource throughout my nursing journey and I still enjoy going to meetings and meeting with other nursing moms, even though I am way past having problems with breastfeeding.” 

Erika Smuts, mom of twins, says, “Take it one day at a time, one feed at a time, and see how it goes. It’s okay to admit that it’s difficult and you need help with breastfeeding.” 

Vania Truter, mother of twins, says, “Find a Whatsapp group or other multiple breastfeeding moms online who you can chat to during the day. Mothering Multiples by Karen Kerkhoff Gromada (www.karengromada.com) is a really useful resource and you can order it online.” 

Useful contacts

La Leche League – www.llli.org – for a countrywide list of breastfeeding group leaders. 
South African Multiple Birth Association (SAMBA) – www.samultiplebirth.co.za – for regional contact details. 

Top tip

“There’s a great video on YouTube that shows a mom describing how she tandem breastfed her twins,” says Truter.