Expecting Twins or more? The practical information you need to know.

So how is feeding twins or more different? Is it even possible? Well yes, Mother Nature is amazing and so are women and our breasts!

Breastfeeding and milk supply can adapt to any number of babies we feed. Our breasts make the amount of milk we require as the system works on ‘Supply and Demand’. Whatever milk volume your babies (or you with a pump) ‘ask’ for, it shall deliver. This is how breasts regulate their supply to your babies, or how we increase supply (by ‘asking’ more frequently) or decrease supply (by ‘asking’ less frequently). The breasts work independently from each other as well, meaning some women are able to feed off just one side if they need to. Clever stuff!

So this is how women are able to breastfeed twins, triplets or more for as long as they choose.

Breastfeeding twins can be more challenging and not just because there are two babies who are being fed. Having twins can often mean that the pregnancy is shorter in duration than women who have a single baby. Twins are more likely to be born preterm by a few weeks. Twins are also more likely to be smaller than single babies. This places twins at higher risk of requiring a stay in the NICU or Special Care Nursery and being separated from their mother for a period of time. Separation after birth is one of the most stressful times for both mother and baby and can interfere with establishing a good milk supply if breast stimulation by baby or through expressing is not started as early as possible.

Establishing a milk supply while my baby is in Special Care

From as early after the birth as possible start hand expressing. The research shows that when women expressed their milk within the first hour after birth they had a better milk supply overall. Most hospitals aim to be helping you express your milk by 6 hours after the birth of your babies, but don’t feel that you shouldn’t do it sooner, just ask for help from your nurse/midwife.

The research advises that you start expressing early and frequently. With twins it is best to try and aim to express 10-12 times in 24 hours, including at least one of these expressions being between 12am-5am, so that stimulation occurs whilst the hormone which makes the milk (prolactin) is at its highest. Often it is advised that you should express every 3 hours which would = 8 times in 24 hours. I prefer to give a total number of expressions to do in 24 hours as this leaves you more control of your day. Your breasts will refill with milk quickly so this means if you feel like it, express every one to two hours and then that leaves you time to have a break and catch up on a longer sleep, then on waking to express frequently again.

Ie. Expressed at 6am, 7.30am, 9.30am, 11.30am, 3pm, 4.30pm, 7pm, 9pm, 10pm, 11.30pm, 3am.

Frequent, short expressions are much more productive for milk supply than infrequent and lengthy (over 30mins) expressing.

Frequent expression can be tiring, so try and express the most when you are near your babies, or have just had or are having a skin to skin cuddle. This will increase the hormones which help your let down reflex and produce more milk. Waking up to an electric pump instead of your babies can be very hard and often women find they are not able to get as much milk as they want at these times. Try taking home one of your baby’s blankets which they have slept on and smelling it before and during expressing. Your sense of smell is really strong right now and this will help those hormones which increase your let down reflex, which helps milk to flow. Looking at pictures of your babies will also do this. Try not to be distracted by Facebook, emails, TV, etc. when expressing; your hormones and your brain just want to think about your beautiful babies to help the milk flow. Try and keep the environment as relaxed as you can.

Milk quantities for twins:

Initially in the first day or two, when expressing it is usual to express tiny amounts, ie. 0.5ml or up to a couple of mls at each expression. Milk tends to ‘come in’ on average around 60-80 hours after birth. This is when you will notice that your breasts feel heavier and fuller. This is often the time when the nurses or midwives will recommend you start to use the pump, if your babies are not yet breastfeeding. It is recommended that you use the hospital grade pump and hire a hospital grade pump too, for home. This pump has a really good motor and can help you establish a better supply; also the option of double pumping can be very helpful. In the first week you may see that you can now express between 30mls each time and up to 60mls or more. By 10-14 days after birth the total 24 hour quantity to be aiming for is 700mls for a single baby and almost double that for twins, ie, 1100-1400mls. This is why when you have twins we recommend you express 10-12 times every 24 hours, and if you have a single baby we advise 8 times every 24 hours in order to reach good volumes of milk. If you are not achieving those volumes by the end of the first week to 10 days after birth it is advisable that you seek help from your nurse/midwife or ask to speak with a lactation consultant. The earlier you get help with boosting your supply, the better for your ongoing future milk supply.

Once you are breastfeeding twins:

When you start breastfeeding your babies it is not essential that you learn to feed them together at the start, or at all, if you prefer not to. You will always receive a lot of advice when breastfeeding, remember you will know what works best for you and your babies, stick with that.

Some mothers of twins prefer to breastfeed their babies together as they find it easier and other mothers find routines too hard and feed their babies on demand. There are no hard and fast rules, what works for some, won’t work for everyone. The main thing to always remember is that in order to maintain a good milk supply, each baby, on average, needs to feed at least 8 times every 24 hours. Some mothers of twins find that they establish such an abundant milk supply that 6 feeds (or roughly 4 hourly feeds) also works well, but this is usually a few weeks down the track.

A lot of mothers of twins find that getting into a routine of 3 hour feeds is often the best way to cope with feeding two babies. You will also find that feeding twins tends to be quicker that feeding one baby. The extra stimulation to the breasts from having two babies suckle at once causes an excellent let down of milk and a faster flow. I have often noticed how quickly twins feed together.

Feeding off both breasts

It is important to ensure you offer a different breast at each feed to each baby. Ie. If a mother always feeds Henry on her right breast and Henrietta on her left breast this could potentially lead to problems in weight gain for one baby or low supply in one breast. This is due to the fact that each baby feeds differently, taking different amounts and the fact that one breast always produced more than the other. The safest option is to make sure both babies feed off both breasts, i.e. 10 am feed Henry feeds off the left and Henrietta feeds on the right. 2pm feed Henry feeds off the right and Henrietta feeds on the left.

Pillows

Do you need a special pillow to feed twins? Possibly yes. As with all things, you will find what works best for you after a few trial and errors, but many women like the twin feeding pillows when they feed twins at the same time.

How are they different from other feeding pillows? Twin feeding pillows are firmer and wider. They allow you to place both babies on either side of you at the same time, this way you can easily attach one onto the breast while the other baby safely lies next to you making attachment to the other breast easy. Of course this can be achieved with other pillows, but not always as easily.

Will I need extra help?

The simple answer is yes; if you can get it. As with any new parent, the first few weeks can be overwhelming, with both joy and excitement alongside times of uncertainty, exhaustion and occasional tears. This is the normal rollercoaster new parents will often describe. With twins you certainly have more cuteness, more cuddles and double the love but also more work. So in these first few days/weeks/months at home make sure you have planned to have as much support around as possible, particularly if you have another child at home who still needs lots of attention. You may find help from relatives/friends is handy in the morning school run/bath-time or in the afternoon when the twins nap best, so that you can get some extra sleep. Where possible, good planning for after the birth of twins is a good idea; filling the freezer with food, ideally enough for a couple of weeks, accepting offers of help to cook, take your other little one out, do your washing, give you hand bathing and drying the twins is sensible, and what friends are for. A material present is nowhere near as helpful as being brought a beautiful meal which will last you a couple of days, or your friend coming over to vacuum your floors/do your ironing! Some mothers of twins prepare to cut back on something in favour of hiring a cleaner for a few hours once a week after their twins are born. These are things to think about during your pregnancy. Financially having twins is different to having one child and planning is key in order to help reduce other stressors in the first few months.

Coping with the change in life when twins arrive is meant to be a shared task. In non-western countries ongoing help for a new mother is normal, in our society being a mother is often seen as a her sole job and responsibility. Don’t be afraid to ask for help, it is not a sign of weakness. Don’t be afraid to have some ‘me’ time off and give dad/aunty/grandma some extra cuddle time with the twins. This is normal and needed. Caring and loving twins is extremely rewarding, but can be very tiring. Looking after ‘you’ is just as important as looking after the twins; make time in your regular schedule for this.

Joining a local twin support group:

Look up local support groups in your area or log onto the  Australian Breastfeeding Association website for more details.

Many new twin mothers find it really helpful to be able to speak with other mothers with twins as life can be quite different from mothers who have one baby. It is often nice to relate to other mothers who are experiencing the same feelings/enjoyment/fears/excitement as you are.

And lastly, never be frightened to ask for help with your breastfeeding from your local Maternal Child Health Nurse or Lactation Consultant.    

You can also check out some of our favourite tops and dresses for tandem nursing.