Establishing and Maintaining Milk Supply Breastfeeding Twins

Is breastfeeding really just supply and demand?

If that’s the case, breastfeeding twins should be no different than breastfeeding one baby. If all breastfeeding success takes is putting a baby to the breast when they demand it, everyone should have success. A twin mom should be able to make enough milk for two babies doing the exact same thing she has done with one baby.

On this claim I must disagree. There is more to it than just supply and demand. Because we know that a lower percentage of twins are exclusively breastfed than singletons, I think it’s fair to assume there more is required for successful breastfeeding than simply a desire to breastfeed and a plan to offer the breast on demand. In my own experience, I have definitely seen differences in breastfeeding my twins than my single babies. This may not be the case for every twin mom, but maintaining a supply adequate to exclusively breastfeed my twins has taken more thought and effort than it did with my other two children.

With that in mind, here are a few suggestions for mothers looking to exclusively nurse their twins that go beyond just supply and demand:

Nurse Newborns Around the Clock:

While establishing supply, a mother should be breastfeeding around the clock. I’m talking new babies here, not six month olds. Newborns can be very sleepy (especially if there is prematurity or jaundice at play). While supply is regulating, I think most twin moms need to be nursing during the day AND at night – even if this means waking the baby up. I don’t necessarily think they have to feed at the same frequency at night as during the day, but I would definitely abide by the general guidelines to feed them at least every 3 hours during the day and to not let them go longer than 5 hours at night until they are 5 weeks old.

Tandem Nurse

Do your best to tandem nurse. This is advice is contrary to most everything I read so take it with a grain of salt, but I am absolutely convinced this is one of the reasons my milk came in plentiful. Due to a lip tie, one of my twins was a lazy nurser. But because I nursed them together, I only needed one baby actively sucking to spur on a letdown. It’s like the concept of drafting in competitive cycling: one cyclist is at the front doing the hard pedaling work and the cyclists behind him are able to go the same speed with significantly less effort. With tandem nursing, one baby can do the work of stimulating a letdown and the other baby just swallows the milk that pours out. Had I nursed them separately, my twin with the debilitating lip tie would not have removed enough milk to give me an adequate supply. By the time I got the tie fixed at 5 weeks, it may have been too late for my supply to recover.

Certainly not every twin mom deals with lip tie, but when you have two babies, your chances of one of them having some sort of difficulty breastfeeding (latching, effective sucking, lip or tongue tie, etc.) is obviously doubled. Nursing them together makes things a little easier on your poor nurser so they drink more. The more milk they remove, the more you make.

Put Those Babies on a Schedule

Should you feed a hungry newborn regardless of your intended schedule? YES, absolutely. Babywise says that multiple times. But scheduling feedings allows you to maintain more frequent feedings even when your baby might be sleeping or not showing signs of hunger. My twins took pretty solid naps from the beginning. If I let them sleep, they would nap 4+ consecutive hours during the day (hate me). Waking them up at the 2.5-3hr mark ensured that they were getting enough calories and stimulating milk production frequently throughout the day.

Feed Before and After Naps

The Babywise method suggests to nurse babies only after they wake from a nap (following an eat, wake, sleep cycle). This is a great model to start with for a variety of reasons, one of which being that a well rested baby nurses better and longer, removing more milk and ensuring adequate supply for you, the mother. A mother who nurses a baby to sleep may find that the baby falls asleep before they get a full feeding.

This has been a great way to start off with each of my babies. But at some point – perhaps when their waketime between naps starts to increase – you may need to switch to nursing before and after naps. Otherwise, the length of time in between each nursing session is too great. If you do not get into the habit of nursing them to sleep in the beginning, this will not be an issue when you start nursing before and after naps. Not all twin moms have to do this – I know there are some that are able to maintain adequate supply only nursing every 4 hours – but I am not. I need the increased frequency of feedings in order to make enough milk for two babies.

Watch Your Supply After they Start Sleeping Through the Night

My babies started sleeping through the night (11-12 hours) around 11 weeks. I did not have a problem maintaining supply after my singleton babies started sleeping through, but my supply did dip after a few weeks of my twins sleeping that long. Babywise mentions this as a potential problem when they say:

“The breastfeeding mom, however, must stay mindful of her milk production. Allowing a baby to sleep longer than 10 hours at night may not provide enough stimulation in a 24 hour period to maintain an adequate supply. While this may not hold true for all mothers, it will have an impact on some, especially those in their mid-30s or older. Therefore, if you are breastfeeding, we recommend that you maintain the feeding that comes around 10:00 or 11:00 p.m.” (pg 98)

I know some people address this issue by pumping at night before they go to bed, but I HATE PUMPING so I just went in and fed them (like a dream feed) before I hit the hay. I had never done a dream feed with my other babies and I actually ended up loving it. I did that for a little over a month. I stopped doing it around the time they started eating solid food and I haven’t noticed the same dip in supply yet (or if my supply has gone down a bit, they are making up for it with food – which is kind of the idea anyway).

Drink Tons of Water

I’m telling you, tons. Logically, if a normal person needs half their body weigh in water (so for me at this point, about 70 ounces) and my babies are drinking somewhere in the range of 25-35 ounces each, I’d need about 140 ounces of water per day. But this IS NOT ENOUGH. I can’t understand the math, but I need closer to 200 ounces every day. I have heard this is true of other twin moms as well.

Watch for signs that you are not drinking enough water: headaches and hard poops (from YOU, not the baby).

Get Enough Rest

It is hard to get enough sleep in the beginning – especially in the days or weeks before your twins have their days and nights sorted out. Like with all important things in life, you must be intentional about it. Do not let yourself be at the mercy of your newborns’ erratic night time sleep. Go to bed early. Take naps. Ask for help so you can lay down for an hour. Find ways to get rest.

I heard this advice when I was nursing my singletons but it never really seemed to make a difference. Little sleep or lots of sleep, my milk output seemed the same. This has not been the case with my twins. There have been multiple times where my sleep has suffered (sickness, insomnia, whatever) and I have noticed a dramatic reduction in milk supply. Mothers of singletons may roll their eyes at this advice (how can I get adequate sleep with a newborn?) but twin moms – you MUST figure out how to make it happen.

Nursing is more than supply of demand, whether you’re nursing one baby or two. It takes planning, effort, and determination. But it is possible – and if you really want to breastfeed your twins, the chances are YOU CAN!

RELATED POSTS:

How To: Nurse Two Newborns

Why Babywise?

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