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A number of issues can make the choice between breastfeeding and bottle-feeding more complicated for multiples than for a singleton.
Multiples are more likely to be born early, and we know that very small or premature babies can find it difficult to breastfeed at the beginning. Spending time in neonatal care can also make them more used to bottle-feeding (although it is usually possible to establish breastfeeding after a stint in hospital). Breastfeeding more than one baby is certainly more demanding than feeding a singleton but can also mean less time spent on making up bottles and money saved on equipment and infant formula.
Many mothers of multiples do breastfeed their babies successfully. Not just mothers of twins but even mothers of triplets have been known to breastfeed their babies exclusively. Your body will respond to the suckling of your babies and produce as much milk as they require.
So, if you want to breastfeed your babies then don’t be put off by the challenges of feeding more than one. Rather, prepare and read up on it as much as possible before your babies arrive, and be sure to get lots of support from professionals and other breastfeeding mothers – especially mothers of multiples – once your babies are here.
Some parents decide that a combination of breastfeeding and bottle-feeding will work best for them. This can work well where breastfeeding has been well established in the first five weeks or so. You may wish to set up a rota for your babies, alternating breastfeeds with bottle-feeds. If you do this, start by bottle-feeding the baby who last had a breastfeed (they may be slightly hungrier as breast milk is more quickly digested, and the bottle-feed tends to go down quicker), then breastfeeding the baby who last had a bottle-feed (the formula takes a little longer to digest and they may not be quite so hungry, enabling them to wait a fraction longer).
Some mothers prefer to breastfeed at certain times of the day, such as morning and evening, so their bodies know when to produce milk, and bottle-feed at other times.
Whatever choice you make, there is absolutely no room in multiples world for beating yourself up about it. Find whatever works for your family, and concentrate on enjoying your babies.
How do I feed more than one baby?
Whatever method you choose, there are four basic approaches:
1.Follow your babies’ cues and feed each baby, as and when each baby seems hungry.
2.Feed each baby (either individually or together) to a strict timetable. This sounds outdated but may be necessary in the early days, especially if your babies are very premature or small. However you will need to check with your health visitor that the routine allows your babies to feed often enough to get enough milk.
3. If one baby wakes up for a feed, feed that baby, then wake the other baby for a feed.
4. If one baby wakes up for a feed, wake the other(s) and feed all the babies at once.
Most people find that a routine of some sort helps to prevent the babies becoming out of synch with each other – which could result in you feeding one or other of them round the clock.
In the beginning it is a good idea to practise breastfeeding one baby at a time, until you and the babies are confident about latching on. Make sure that feeding is properly established before you leave hospital: ask to see the hospital lactation consultant. It’s worth asking if they have a feeding advisor who is specialised in breastfeeding multiples.
Some mothers reserve one breast for each baby (although if babies have very different appetites, this can make the breasts lopsided). Others swap the babies between breasts at each feed.
There are various ways in which you can breastfeed two or more babies simultaneously. It is difficult to do this in a single bed or a hospital chair, so experiment when you get home:
• Tuck one baby under each arm
• Hold one baby in the conventional position, with the other baby parallel
• Hold both babies in the conventional position, lying across one another
• Lying on your back, with the babies lying on your tummy.
You may find a V-shaped pillow or a pillow that straps round your body helpful in supporting the babies during feeding.
Download Tamba’s booklet, Breastfeeding More than One, for more detailed information and helpful illustrations on how to breastfeed multiples and for more support contact one of Tamba's Breastfeeding Peer Supporters
Bottle-feeding is a more expensive option with multiples. However, one major advantage is that both parents – and anyone else – can share in the task. This may be an important consideration for those parents who also need to spend time with their other children and for families coping with three or more babies at once.
Current guidelines for preparing infant formula are that to reduce the risk of infection each feed should be made up at the time it is needed and that the water should be at no less than 70°c when the formula powder is added. If not at home, vacuum flasks can keep water above 70°c for several hours. The powder can then be added when the feed is required.
Always use the scoop provided with the infant formula powder and add the exact amount as instructed on the label. Then cool the feed to feeding temperature by running the bottle under the cold tap or placing in a container of cold water
Storing and then using made up formula milk may increase the chance of a baby becoming ill and should be avoided. Discard any feed that has not been used within two hours.
Make sure you understand the basics of feeding and sterilisation before you leave hospital. In hospital, you will probably feed the babies one at a time because of the limitations on space. When you get home, you can experiment with the many different approaches to bottle-feeding two or more babies at the same time.
• Put the babies in baby seats or portable car seats, or prop them against cushions on the sofa and sit in front of them.
• Lie on a bed, propped up by pillows. Put one baby on each side of you, with their legs towards you and their heads raised on pillows. Do not leave them unattended.
• Sit on a sofa with the babies lying beside you each propped up on one of your legs.
• Cradle one baby in each arm, while holding the two bottles, and twist your wrists and hands round so that the bottles go in the babies’ mouths.
• Feed one baby yourself, and get your partner or another person to feed the other. Swap babies at each feed to make sure you spend time with each one.
Please note: babies should never be propped up with a bottle or left unattended during feeding as there is a serious risk of choking.
For more on breastfeeding, bottle-feeding, weaning, and developing a routine that works for your family, download Tamba’s free guide, Twins, Triplets and More: The First Year.
Follow the links to find out more about managing in hospital, coming home, bonding, sleep and co-bedding, concerns and development.