Breastfeeding Twins

WHAT YOU SHOULD KNOW:

Breast milk provides the best nutrition for your twins. Twins are often born preterm (early) and may have a low birth weight. Preterm babies are at higher risk for problems, such as infection. Breast milk has substances in it that are good for the health of your twins. Breastfeeding helps protect your babies from infection. It also may decrease your babies' risk for allergies and other medical conditions, such as asthma and diabetes.

INSTRUCTIONS:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

How to sit when breastfeeding twins:

You can breastfeed your twins one at a time or at the same time. Breastfeeding them at the same time may decrease how much time you spend breastfeeding each day. Sitting in a comfortable chair with arm and back support may work best. Using a breastfeeding pillow for twins can help support your arms and the babies’ heads. You also may want to use a footstool to help you hold and support your babies.

How to hold your twins when breastfeeding them at the same time:

Ask your partner or another person in the home, if available, to help you position your twins correctly.

• Double football hold: Hold your babies' heads in each of your hands. Your babies will be lying down with their bodies under each of your arms.
  
  
• Double cradle hold: Support your babies' heads in each of your arms. Your babies' heads may rest in the bend of your arm near your elbow. You will hold your babies in your lap, across your abdomen.
  
  
• Cradle and football hold combination: Hold one baby using the football hold and the other baby using the cradle hold.

How to breastfeed your twins:

• Help move each of your baby’s heads to reach your breast. Hold each baby’s head to help him latch on to your breast. Bring each baby’s lower lip to the areola (dark circle around the nipple) first. Each baby should have as much of the areola in his mouth as he is able to get. Once each baby is latched on, you should feel as if he will not separate from the breast easily.
  
  
• If you are breastfeeding one baby at a time, you can hold the baby’s hand. This will help prevent the baby’s hand from getting between his mouth and your breast. You also can hold your breast to help it form to your baby’s mouth.
  
  
• Allow each baby to breastfeed for as long as he is able. Do not set any time limits for how long each baby should feed.

How often you should breastfeed your twins:

• Your twins may let you know when they are ready to breastfeed. They may be more awake and may be moving more. They may put their hand up to their mouth. Crying is normally a late sign that your twins are hungry. Crying may make it hard for the babies to latch on to your breast.
  
  
• Breastfeed your twins between 8 and 12 times each day. This includes waking to breastfeed your twins during the night. If one or both babies is sleeping and it is time to feed, lightly rub your finger across the baby’s cheek. You also can do this under the chin while holding the baby near your breast. This may work if one or both of your babies falls asleep while feeding.

Having enough breast milk for your twins:

The more often you breastfeed your twins, the more milk you will make. Over time, the amount of milk you make will increase, so you are able to feed your twins what they need. You also may need to pump milk from your breasts. Pumping breast milk can help increase how much milk you make. Pumped breast milk can be stored to use when you cannot breastfeed. If you are away from your twins and not able to breastfeed, pump your breasts every 3 to 4 hours.

Caring for yourself when breastfeeding twins:

• Get enough rest: Having twin babies can make it hard for you to get enough rest. Getting enough rest and sleep may help decrease your tiredness and improve the breastfeeding experience. Try not to sleep on your stomach because the pressure on your breasts may decrease the amount of milk you make. Talk with others in your home about making a sleeping schedule that will allow everyone to get enough rest.
  
  
• Drink enough liquids: Drinking plenty of liquids each day may help increase the amount of milk you make. Ask your caregiver how much liquid you should drink each day.
  
  
• Eat a healthy diet: Eating enough healthy food can help your body make enough breast milk. You may need to eat up to 2700 calories each day. Your caregiver also may have you take vitamins, including pregnancy vitamins, and vitamin D. Talk with your caregiver before taking any vitamins or supplements. Talk with your caregiver about what foods you should eat and how much. Together you can plan the best diet for you.
  
  
• Manage your stress: Increased stress can decrease your supply of breast milk. Relaxation can help decrease your stress and help you feel better. Ways to decrease stress include holding your babies' skin against your skin. Deep breathing, meditating, and listening to music also may help you cope with stress. Talk to your caregiver about other ways to manage stress.
  
  
• Talk to your caregiver before taking any medicines: This includes all prescription and over-the-counter medicines. Some medicines may decrease the amount of breast milk you make.
  
  
• Do not smoke: If you smoke, it is never too late to quit. Smoking may decrease how much breast milk you make. Smoking harms your body in many ways. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. Quitting smoking will improve your health and the health of those around you. Talk with your caregiver if you smoke and need help to quit.
  
  
• Limit or avoid drinking alcohol: If you choose to drink alcohol, breastfeed your baby before you drink it. Do not breastfeed your baby for at least 2 to 2 ½ hours after having one drink. One drink of alcohol is 12 ounces of beer or four ounces of wine. One ounce of liquor, such as whiskey, is one drink of alcohol. Talk to your caregiver if you drink alcohol and are breastfeeding.

CONTACT A CAREGIVER IF:

• You, or one or both of your twins, have a fever (high body temperature).
  
  
• You do not think your babies are getting enough breast milk.
  
  
• One or both of your twins is not gaining weight or looks as if he is losing weight.
  
  
• You have pain and swelling in one or both of your breasts. Your breasts also may feel warm.
  
  
• You have nipple pain. Your nipples may look red, dry, and cracked. They may have scabs on them.
  
  
• You have burning pain in one or both of your nipples that shoots into your breast.
  
  
• One or both of your twins has new or increased yellowing of his skin or the whites of his eyes.
  
  
• You are so tired you do not want to breastfeed any longer.
  
  
• One or both of your twins is having less than three bowel movements (BMs) each day. After four months of age, your twins may only have one BM each day.
  
  
• One or both of your twins has less than six wet diapers in one day.

SEEK CARE IMMEDIATELY IF:

• You are feeling very depressed (deep sadness).
  
  
• You feel a lump in your breast. The lump may be tender (painful when touched).

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.