Breastfeeding Multiples
Breastfeeding twins or even triplets is exciting and daunting all at the same time. Multiples often present a new mother with a variety of breastfeeding challenges that can be worked through and supported by a Lactation Consultant like the highly skilled and experienced Leanne Rzepa RN BN IBCLC.
Leanne is the owner and founder of Nourish Lactation Consulting and has been supporting breastfeeding families for over 20 years.
Nourish has worked with many multiple feeding families over the years to help them achieve their feeding goals. We provide in-home breastfeeding support and education on an as needed basis to families in Calgary and surrounding communities. Nourish also offers complimentary 24/7 email/text/phone support which is an invaluable service to our mamas!
Below are some of our suggestions and recommendations for breastfeeding multiples:
Begin antenatal colostrum collection at 36 weeks gestation once you have cleared it with your primary care provider
Refer to the First Droplets website on how to hand express your colostrum (www.firstdroplets.com)
Nourish can provide you with a colostrum collection kit
Once your babies are born, try and breastfeed them within the first hour after birth
If they are struggling to latch/feed effectively, feed them either freshly expressed colostrum or a few thawed syringes of colostrum
In the first 24 hours after birth, babies drink ~2-10mls/feed
If your baby has a low blood sugar, it may be medically indicated to supplement with expressed milk and/or formula
If your babies are having difficulty latching, it is important to begin regularly hand expressing every 3 hours
After 24 hours of age, if the babies still aren’t latching effectively, begin pumping with a hospital grade pump with continued hand expression after
Breast pumps don’t do the best job at removing colostrum from your breasts but are an important part of breast stimulation
Your hands generally do a better job at removing colostrum in the first few days until your milk comes in
By 24 hours of life, your babies should be eating ~5-15 ml/feed
If your babies aren’t breastfeeding effectively, continue pumping/hand expressing every 3 hours to ensure your supply comes in robustly on day 3-4
Hold your babies skin to skin as much as you can
Syringe or cup feeding is the preferred method of feeding colostrum in the first 2-3 days after birth
You can finger feed them by cleaning your hands, putting on a glove, have them suck on your pointer finger, then slide the syringe in next to your finger. When your baby begins to suck, slowly depress the plunger to allow them to drink your colostrum
After 3 days of life, if they still require regular supplements, it is recommended to begin bottle feeding in addition to breastfeeding
For bottle feeding, Nourish recommends using the Dr Brown’s bottle feeding system (preemie or newborn nipple)
Ensure you are using the pace bottle feeding technique
Feeding can look different throughout the day/night: Some mothers will breastfeed one baby for ~20 minutes (a bottle top-up may be required after breastfeeding) and Dad will bottle feed the other baby, then mom will pump both breasts
Or-breastfeed one baby, dad tops-up and then mom will breastfeed the other baby, dad top-up, pump both breasts after
Alternate breasts for the babies at each feed
Tandem feeding is typically the goal for most breastfeeding mothers
Each baby needs to be breastfeeding well and gaining weight appropriately before tandem feeding can be done consistently
Consistent tandem feeding sometimes takes a month or longer to establish depending on the gestation of the babies at birth and their effectiveness and efficiency at breastfeeding
Ensure you stay well hydrated and have healthy fiber filled snacks handy
Listen to your body, rest when you need to and if you happen to miss a pumping session because you are exhausted-that is ok!!
Late preterm babies born 3-6 weeks early ( 34-37 weeks gestation) may have special feeding considerations
They tend to be sleepier and may not be able to feed as effectively as a full-term baby
You will have to wake you baby at least every 3 hours to feed until they are back up to birth weight which can sometimes take 2 weeks
It is normal and expected for your late preterm baby to require supplements in addition to breastfeeding
Late preterm babies are more at risk for developing jaundice
Nourish is here for you Mama!!
Warmly,
Leanne Rzepa RN BN IBCLC