Breastfeeding Multiples

It is possible to breastfeed more than two babies, exclusively?!

Studies show that most women are capable of producing sufficient milk to exclusively breastfeed triplets and even quadruplets.

It is ultimately the mother’s choice whether she sees chance to breastfeed her babies, but here are a...

Few Facts to Consider:

  • Breastfeeding can save up to 10 hours of work per week compared to formula feeding. 
  • Breastfeeding provides superior bonding with each baby, especially if the mother practices skin to skin contact
  • Breast milk is free, whereas formula costs for multiples can get quite expensive. 
  • Babies, who are fed formula, are at higher risk of getting ill. Since most multiples are born preterm, the risk of illness is even higher, making the consumption of breast milk even more important. Read more about the immunity that breast milk offers. 


Before Your Babies are Born

  • Attend a childbirth preparation class. Find out about avoiding unnecessary birth interventions that can cause breastfeeding problems. 
  • Find a breastfeeding counsellor that has experience in helping mothers who breastfeed multiples. 
  • Rent a hospital grade, double action, electric breast pump. Make provision for storage of breast milk.
  • Make sure that you have someone available to help with household chores for the first few weeks after your baby's birth. 
  • Look after yourself; consume enough calories before and after birth. 


Tips for Breastfeeding Multiples

  • Early feeding after birth is essential. 
  • Breastfeed on demand.
  • Incorporate lots of skin to skin contact. 
  • Have the babies in the same room as yourself. 
  • Begin expressing milk at least 12 times per 24 hours, if babies are in intensive care and unable to feed for the time being. 
  • The use of supplements and pacifiers can interfere with establishing a milk supply. Even just one bottle of formula can change the ph in a baby’s gut and increase the risk for illness and other issues. 
  • Keep in mind that if you (Mom) have any conditions such as diabetes or have had a c-section, your milk “coming in” will be delayed.
  • Mothers can breastfeed two babies at once. There are special breastfeeding pillows that make this possible. Different breastfeeding positions for this include the double football hold, the double cradle hold, babies facing each other or the parallel hold. Breastfeeding two babies at once, will also increase a mother’s milk supply. 
  • Kangaroo care can be very helpful, especially if your partner can participate. 
  • Co-bedding of babies has shown to be very rewarding. Babies usually snuggle together and show better temperature regulation. 
  • Breastfeeding your twins exclusively


Information that a Mother Might Want to Keep Track of

  • Number of feeds per 24 hour period, for each baby as well as the duration of each feed. 
  • Pumping sessions and the amount of milk expressed. 
  • Any supplementary feedings and the quantity given. 
  • Number of wet and dirty diapers as well as consistency of stools. 
  • Amount of time each baby spends in kangaroo care. 
  • Weight gain of each baby.
  • Sleep patterns of each baby. 


Supplementation May be Needed When

  • The mother’s milk supply is low or is taking too long to “come in”.
  • The mother has PCOS, which is usually associated with a low milk supply.
  • The mother experienced problems during birth that have caused a low milk supply. 
  • One or more of the babies require a milk fortifier. 
  • One or more of the babies has a problem that keeps him/her from breastfeeding. 
  • The mother has had more than quadruplets. 
  • The mother feels that she needs help or extra sleep. 


If the mother needs to supplement and cannot provide the supplement herself, via expression, it is best to consider donor breast milk from a reputable breast bank, and then her last option should be formula.


Tips for Breastfeeding Multiples at Night

  • Nurse whilst lying on the side position, this gives the mother a chance to sleep while breastfeeding. 
  • Wake the other babies to breastfeed after each other; this will give the mother longer stretches of sleep.
  • Let the babies sleep in the same bed together. Multiples sleep better when they are together. Co-sleeping with Mom in bed can also help, as long as the mother takes into account safe co-sleeping guidelines. 
  • Keeping a co-sleeper crib on the side of the mother’s bed. Must be of the same height as the bed, with no gap or railing in-between.


Top of breastfeeding multiples page


Tracy Behr, CBC, CLD (CBI)

Reference: Course information through Childbirth International on the physiology of breastfeeding / breastfeeding multiples.


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