Ask the Moms: How to Tandem Nurse

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 has written about how to successfully tandem nurse before, but it’s been a few years. In this post, we share the current HDYDI Moms’ experience with tandem breastfeeding. We hope that this can give you some ideas and insight if you are embarking on the adventure of breastfeeding twins!

Skip to: Tandem Nursing Experiences | Pumping and Nursing Experiences | What Helped | What Hindered | Equipment | Support Personnel | Positions | Tandem Nursing in Public | Prematurity | Twin Nursing Ebook

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What is your experience with tandem nursing? How long did you nurse, and why did you stop?

Janna: I successfully tandem nursed my twin boys starting at 3 weeks old. The lactation consultant told me that we were not ready for tandem nursing. Lucky for us, my mom was at the appointment with me and she thought the advice was crazy. My help was going home when the babies were four weeks old, so she defied the woman’s authority and suggested we just try tandem nursing as soon as I got home from that appointment. It was completely successful and with our set up, actually easier than nursing one at a time. From that point on, I nursed the boys at the same time every time.

RebeccaD: I tandem nursed in the hospital (healthy 38 weekers) but hit a glitch when I was re-hospitalized later in the week with a uterine lining infection. One baby stopped latching altogether. I spent a day in bed with him re-learning how to breastfeed. We were back to tandem feeding by about 10 days old. No lactation consultant was as valuable as my mom and mother-in-law constantly cheering me on, telling me I could do it, and supporting me as I figured out how. Their faith in me helped me trust my own instincts. I tandem-fed for most feedings until the boys were 9 months old; by then they were so efficient and so big and wiggly that back-to-back feedings were easier.

Mercedes: As a pregnant twin-mama-to-be, I envisioned myself breastfeeding with the support of a styrofoam-filled “Breast Friend” as I cradled the heads of my peaceful babes while they suckled and intermittently sought out each others hands. It didn’t work out that way. Uncomfortable and pretty much hating life, I soon decided that individually nursing my twins was much more reasonable, although it did take up all of my time. It was my number one (and two) priority, so I made it work. As the twins got older, tandem feeds actually became easier since they required less effort and orchestration on my part. Now that my nurslings are 15 months, it’s pretty much the only way we do it (unless it’s a nighttime feed), because the nursing jealousy is pretty rampant.

Sadia: I tried for 5 months, but was never able to use tandem feeding as my primary mode of breastfeeding. I really wanted to make it work, because I found myself breastfeeding 12+ hours a day while on maternity leave. I needed another adult (my husband) present to hold the first baby while I latched the second on and held her. With both my babies coming home at under 5 lbs and a month before their due date, they didn’t have the neck control to nurse without one adult hand supporting their body and another their head. No number of pillows seemed to raise them up high enough to not need manual support from a parent. When my husband deployed to Iraq, the babies were 5 months kid and there went my extra hands. Also, J went on nursing strike shortly after Daddy deployed, so I had to switch her to expressed breast milk (EBM) from a bottle. I didn’t even try tandem nursing for nighttime feeds; I didn’t trust myself not to doze off, especially since I was working full-time.

Dory: Whenever I have a second set of adult hands (my husband, my mom, or my mother-in-law), I like to tandem nurse. It is so much easier to get them both done at once (no leaking of the other breast or a crying, hungry, waiting baby) and faster (sometimes as quick as 30 minutes, as opposed to at least 1 hour if one-on-one feeding). Because my babies are 2 months old, I can’t speak to stopping tandem nursing, but I imagine that once they get really wiggly (and big), I won’t be able to keep it up anymore.

RachelG: I tandem-nursed until around 8 or 9 months, when my supply wasn’t really enough to satisfy either twin for long. I dealt with supply issues from the very beginning, despite help from lactation consultants, so we tandem-nursed, then supplemented with bottles of formula.

ldskatelyn: I tried tandem nursing in the beginning. I found it was a great thing to do during those nighttime feedings so that I could get back to sleep sooner (aka, get sleep), but I always needed help getting them set up to nurse, which meant waking up my husband. After realizing that my husband was a blessedly sound sleeper and didn’t handle lack of sleep as gracefully as I did (and who also had to work a full time job), I decided I would stick with feeding them one at a time so that I could do let at least one of us get sleep. I also came to love that one-on-one time with each of my girls, where I could just focus on one of them, even if it meant listening to the other cry for 10 minutes.

Tandem nursing dog pile.
Tandem nursing dog pile, featuring Mercedes and her duo.

What were your experiences with pumping and nursing?

Sadia: I tandem nursed one baby on one breast while pumping on the other pretty consistently. This worked great for me because tucking the flange into my bra left me two hands for the nursing baby and pumping gave me EBM for daycare feelings. I returned to work when the babies were 11 weeks old (4 weeks adjusted) and my output fell precipitously. Once J went on nursing strike, “tandem” nursing with the pump and M was my primary means of getting J her breast milk. I could pump so much more with a baby plus the pump than with the pump alone. I tried many, many pumps, and the Medela Pump-in-Style (with extra-wide flanges) was the best fit for me, but babies just fit me better.

Janna: After our morning tandem feed, I would put the boys in bouncy chairs and tell them stories while I used the double breast pump for about ten minutes. I occasionally pumped again after another feeding session if the boys were otherwise occupied and we knew we needed milk for an outing coming up, but mostly I just fed them at the same time in the brown recliner chair every two hours when they were hungry.

RebeccaD: I pumped when I was in the hospital without my boys (when they were 5-8 days old), and when I felt overly full for about the first month. I demand-fed, so there was no predictable schedule, which made direct breastfeeding much easier. What if I had just pumped and then they wanted to eat? It made more sense for me to cut out the middle man. I worried constantly about not having a big freezer stash, and having to be the one to do every single feeding was very taxing. But ultimately, direct feeding worked best for me and my little ones.

Mercedes: I used the pump only very occasionally in the first several months. Sometimes what I would do is start with the pump on both breasts and then get the babies latched on.

Dory: When I was in the hospital with Audrey and David, I needed to get my milk flowing, so I would pump for 5 minutes before nursing. I would then nurse them until they were finished. Then I would try to pump some more and give it to them in a syringe. Once we got home (4 days old), I would continue this pattern, but I wouldn’t let them nurse any longer than 20 minutes. If they nursed any longer, they would use more energy than they would get in calories. I would then supplement afterwards with whatever I had pumped beforehand. Once they passed their birth weight (after their 2 week checkup), I stopped pumping and supplementing. Now, I simply pump whenever I feel like they haven’t emptied me out completely. I have to say that, at 2 months old, they do a pretty good job, and we have our nursing sessions down to 10 minutes latched on! I really only pump every other day in order to build up a supply for when I go away during feedings.

RachelG: I never pumped while nursing. Both babies always ate at the same time, and for much of my nursing life, my pump was set up in a different room from the one I usually nursed in.

ldskatelyn: I never even thought about pumping on one breast while nursing on the other, mostly because my children were always fed back to back. I usually only pumped at night, right before I went to bed, since they were sleeping through the night (12 hours) and I would be engorged and sore by the morning if I didn’t. It also gave me breast milk to supplement their feedings with if they needed it, or to mix with their baby cereal.

What helped the most with tandem success?

Sadia: My husband’s support was key. Knowing that other MoMs, including a triplet mom in the family and a twin mom from my MoM club had done it before me was very inspiring. My husband had observed his triplet cousins breastfeeding when he was a pre-teen and had a surprising amount of breastfeeding experience to offer. I’m so glad that I researched a ton about breastfeeding multiples before giving birth. I was shocked to discover how many people around me just assumed that it couldn’t be done, particularly since I had a career outside the home. Fortunately, my boss was also a breastfeeding mother; her support made it easy to adjust my work environment to allow for pumping time and space.

twnnurs4Janna: My recliner/boppy set up next to an end table made nursing both boys at the same time so easy. I would sit down in the recliner and position the boppy around my stomach with the ends of the boppy situated up on the recliner arms. Then I would lean down and pick up the babies off the floor and put them in the “football hold” laying on the boppy pillow. Once I got them latched, I was hands free and could pick up the food, water, book, remote control, etc… on the end table next to me. I also had my laptop set up on the other side of me, so I could read blogs and email while nursing. My boys ate every two hours for at least thirty minutes, so being hands free and having other things to do really made it easier for me.

RebeccaD: The biggest factors in my success was the support of experienced nursing women in my life — other MoMs, my mother, and mother-in-law — and my husband. The women helped me to develop my nursing relationship with each of my boys, as well as persevere in tandem feeding. My mom stayed with us for 2 weeks after the boys were born, and my mother-in-law for 5 weeks. They would get up at night to help me get everyone in place for feedings. Then they would tell me stories about nursing their babies. It was so lovely. I felt like I was being admitted into a special, ancient circle of wisdom. My MoMs group had several nursing women, and we shared many emails in the wee hours! My husband showed his support by making nursing a priority, by bringing me food and water, and by showing me so much love as I figured it all out.

Mercedes: Time and confidence. Tandem feeds were not for us in the beginning. Over time they just started happening naturally.

Tandem nursing older twins
Tandem nursing older twins.

Dory: For me, I couldn’t have done it without my husband, mom, and mother-in-law. They are my biggest supporters and helpers during nursing. While I get into position in my chair with my pillows and burp cloths, they get the babies ready (taking off sleep sacks or waking them up enough to latch on). Then, while one baby is finishing up, they take the first-to-finish baby off of me to change and re-dress him/her. In addition, I had a very emotional time during the first few weeks in regards to nursing. I wanted to give up every single time I sat in that chair, but they were my cheerleaders (my husband especially), encouraging me to work through it. I’m so glad I did, too! Now, I love my nursing time!

RachelG: I had a fantastic postpartum nurse in the hospital who helped me figure out how to tandem nurse. She showed me how to position the babies on pillows, support their heads properly, and help them relatch when they took a break. I don’t think I could have figured out how to do it on my own without her help early on.

What were the biggest obstacles to tandem nursing?

Sadia: We faced a lot of challenges. For starters, my 33-week preemies spent 16 and 21 days in the NICU. I wasn’t allowed to try to breastfeed J even once the whole time my girls were hospitalized, so I had no opportunity to try it out until after J was home. I had a full time job to which I returned at 11 weeks postpartum, so I couldn’t breastfeed during the day on weekdays. The exhaustion of single parenting twins with a full-time job took its toll on my supply too. I had a very poor supply with the pump, despite taking fenugreek, pumping on a schedule, and having been able to produce enough milk for exclusive breastfeeding during maternity leave. Add to that my husband’s deployment to Iraq and J’s nursing strike, tandem nursing just wasn’t in the cards for us. My huge nipples didn’t help at all. I used standard size pump flanges the first few weeks, and they ripped my breasts to shreds.

Janna: If I hadn’t tandem nursed, I wouldn’t have been able to continue nursing my boys after my help left at four weeks. The nurses and lactation consultant in the hospital and a different lactation consultant we saw at an appointment at three weeks old ALL told us that I couldn’t even attempt tandem nursing until the boys were older, had an expert latch and I was an expert at single nursing. I am so grateful that I didn’t listen to this advice. Everyone should try tandem nursing whenever they want. If it doesn’t work, fine, then go back to single nursing, but if it does work (like it did for me) you can start tandem nursing right away and not have to figure out what to do with that second baby while you’re nursing the first!

RebeccaD: My own physical health was a big obstacle to tandem nursing. The stress of a long (38 week) twin pregnancy, followed by an emergency c-section, subsequent uterine lining infection, and abscess on my tailbone, made it difficult for me to sit up, let alone try to support tiny heads, etc. I did nurse individually side-lying for a while, but I wasn’t able to sleep that way. Tandem nursing turned out to be the best way for me to get rest and feel connected to my babies. Another obstacle was nursing agitation – an intensely uncomfortable feeling that can happen during tandem nursing. I got through it, mainly by distracting myself, and it greatly diminished over time.

Carolyn: I did tandem for a little while once we were home from the NICU. It never felt comfortable, no matter how I set myself up. It was a “me thing” and not an issue with either baby, my nursing pillows, or where I did it. It just wasn’t for me. I had a very easy time nursing, which is maybe why I chose to breastfeed my boys individually, to get it done as fast as possible and move on to the next thing or get back to sleep. (We were feeding every three hours in the early days). I did sacrifice more sleep than I would have liked to, but I got the job done and nursed for about 9ish months. We had EPM bottled, supplemented with higher calorie formula and nursed for the first several weeks in NICU until the babies were stabilized. Tandem feeding was not a negative experience for me, just not my preference.

recliningMercedes: Setting up my “station” and getting into position on my own, at the beginning was very challenging. The only position I found comfortable was a sort of double cradle while reclining position, and this was not sustainable for very long since my hands were not free to do anything else (like scratch a nose, answer the phone, etc.) Now the challenge is that they are so big they can physically overwhelm me at times! The easiest thing to do is just to lie down and let them have at it.

Dory: Early on in nursing (Weeks 1-4 or 5) I really hated feeling “stuck” in that chair. Once I got in, I couldn’t get up without someone getting the babies off of me (especially when I was recovering from giving birth). I wanted to give up every single time I had to sit down to nurse. I didn’t like being a prisoner of the chair and pumping. I felt like I just wasn’t making enough milk (even though in reality I was making more than enough). I felt like I couldn’t do it (emotionally or physically). I was just in a funk. Then, magically around 6 weeks, when my babies were at their fussiest, it was like a light turned on. I was what they wanted and how they stopped crying. Me! Yes, I was feeding much more often than my normal because of their neediness, but I could soothe my babies, and I loved that feeling. No one else could help them like I could. Everyone else could change diapers, hold, and cuddle, but only I could feed them with the nourishment they needed. It took them being at their fussiest for me to love tandem feeding! Now that they are starting to eat fewer times a day, I really truly enjoy our nursing sessions.

RachelG: I found it hard to figure out how to get both babies onto and off of my lap without help. Once I sat down in my chair and got everyone positioned there, we were stuck for hours until I found a way to dis-entangle the babies and get up again.

What equipment was helpful?

Sadia: My breast pump was my saving grace, an alternative to tandem nursing that kept me from going completely insane. I loved my chair with arms. Since my babies were so tiny, a narrow chair actually worked very well for us. Pillows helped relieve the fatigue on my arms, breastfeeding each baby, as I did, for 45 minutes each every 3 hours. I loved my magazine subscriptions. I read those issues of Time, Newsweek and National Geographic from cover to cover.

Janna: A chair with arms and a boppy pillow to support the boys was absolutely helpful. I needed something to do while nursing, so I didn’t go crazy with boredom. A towel tacked over the high window in the living room to cover it so that the workmen fixing the wall outside couldn’t see me nursing.

RebeccaD: The nursing pillow. The Twin Brestfriend wasn’t perfect, but I couldn’t have tandem nursed without it. If I had it to do over again, I would invest in a big recliner to nest in with the nursing pillow. As it was, I had a pretty good set up – armchair, then loveseat, and finally floor. The armchair + nursing pillow held the boys up high when they were really little. I had to have someone hand them to me once I got settled in. When I moved to the loveseat, I could place one baby in the Boppy, put the pillow on over my head, pick up one baby, sit down, then pick up the other baby and latch both on. Once they could crawl, I sat cross-legged on the floor with the nursing pillow, pulled them both on, and when they were done, they just rolled off and crawled away! I would have gone INSANE without distractions – books, iPad, phone. And I always had a little table with water and snacks nearby.

RachelG: I have a big armchair in my living room that I called, “The Chair of Doom,” while I was in the thick of nursing infants. I rarely left it. It was big enough and had enough support that I could juggle everything I needed to there. I had lots of pillows that I used  behind my back, under my nursing pillow, on the sides, etc., just to make everything the right height. I had a small tray table next to me with a bottle of water, remote controls, snacks, etc. Once I was home alone with my kids, I set up a changing table on one side. My changing table came from Ikea, and my mom cut the legs down a little so it was the same height as my chair. I could use it as a staging area for getting kids put onto or taken off of my lap for nursing.

Dory: There are a few pieces of equipment that I couldn’t live without. First, when I am on the couch, in bed, or in a low-armed chair, I have to use my Twin Z nursing pillow. I discussed it during my pregnancy, and it is just as wonderful as I expected. If you have a higher-armed chair, however, it may not work out well. For our armchair in the  nursery (which has very high arms), I use a My Brest Friend (for singletons- the twin version is too large for this chair) with a Boppy Cuddle pillow on top of it. I then place two burp cloths under the babies’ heads, and they latch on using the football hold.

What role did lactation consultants play? Your spouse? Other MoMs? Friends? Family?

Sadia: The NICU nurses were extremely supportive of my pumping and providing expressed milk to the babies, but were strongly against my trying to latch the babies on because of their prematurity. Lactation consultants were useless. Their attitude of amazement that I was even trying made me feel that they’d already decided that I was destined to fail (at breastfeeding, period, forget tandem nursing). The one exception was a consultant at a local breastfeeding supplies store who suggested a nipple shield to counter J’s strike. It didn’t help, but at least she tried to provide advice instead of telling me to give up. Other MoMs and my husband were far more helpful, although their support was more emotional than informational since their experience was with full-term babies. The only preemie mom I knew never had her milk come in, so I was alone in the preemie nursing boat.

Janna: I concur. Lactation consultants were useless. The ones I had just didn’t have any experience with moms successfully nursing twins. Instead it was my mother, mother-in-law and husband who were incredibly supportive, helpful and encouraging. Also, I had two close friends who were currently successfully nursing their singletons. While their advice and support weren’t necessarily specific to twins, they were invaluable with basic nursing questions. For example, NO ONE (not the pediatrician, lactation consultant, no one) had told me about growth spurts so I was almost ready to give up when my boys started crying and acting starving and demanding to eat extra at 6 weeks old. I assumed I wasn’t making enough milk. My friends emailed me back right away and told me it was the (normal, common) 6 week growth spurt and to just keep nursing them all the time & expect to be exhausted, sore and frustrated for a few days and it would all go back to normal… and it did.

RebeccaD: What I needed: confidence, reassurance that I had the basics, and a twin-specific logistical strategy. What I got: two different programs for each baby. Being a twin mom is all about creating a bridge between your babies’ individual needs and your ability, as one person, to meet those needs. Breastfeeding was a serious crash course in this for me. So, my first lactation consultant was basically awful because she treated my babies like two singletons and made me feel horrible for being unable to be two mothers. Luckily I had other support and figured it out. Six months of exclusive breastfeeding later, I started having supply problems, and a different lactation consultant was a wonderful help. I credit her with my ability to continue nursing to 13 months for one and 15 months (and counting!) for the other. But I came into that consultation with a lot more knowledge and confidence. I could tell her, “That won’t work with twins, what else ya got?”

Dory: Our first pre-baby class was a breastfeeding class for couples. It was amazing! I thought it would be silly to take such a class, as I figured I would get all I could at the hospital. I was wrong! There is so much to learn and think about, and it was helpful to have that base understanding. After giving birth, I can’t stress how important it is to talk to the lactation consultants at the hospital, before you come home. We made sure that we got extra time with them to make sure we were getting all of the hints we could. I asked questions over and over, and they were more than happy to help us. They were so sweet and treated us like superstars (get used to it when you are parents of twins!). The were incredible! We also were able to follow up in our pediatrician’s office during the 1 and 2 week appointments. The woman we saw was a lactation specialist. Score for the nursing moms! She was the one that told us not to let them nurse any longer than 20 minutes early on (any longer and they would burn too many calories).

RachelG: As I mentioned earlier, I had a fantastic postpartum nurse who helped me figure out latch, positions, etc. I worked with lactation consultants, but they focused mostly on helping me increase my supply and improving my son’s latch. They weren’t hugely helpful, in that my supply never increased substantially and my son figured out the latch thing on his own eventually, but at least I had the peace of mind that I had tried everything.

ldskatelyn: The hospital lactation specialist was very good about encouraging me to try tandem feedings, and taught me the different positions. My husband and mother-in-law (who was a nurse) were helpful once we got home.

What positions worked or didn’t work for your family?

Tandem nursing positionsSadia: The football hold worked best. My girls hated to be crossed and I felt like I could support them better football style. Our typical setup was as follows:

  1. My husband sat in the chair.
  2. I picked up both babies, one in each arm, cradle hold.
  3. I sat in my husband’s lap.
  4. He held one baby, cradle style across my lap, while I latched on the other in a football hold.
  5. He held the nursing baby while I latched on the second.

Janna:  I had to use a boppy, in a recliner with arms. I put the boppy around me, with the ends of it rested up on the recliner arms. Then I lay the boys down on the boppy in the “football hold” and both my boys were up at the right level, leaving my hands free (for eating, reading books, emailing, etc…). It was ideal at home. I never did try any other position because this one worked so well for us.

bftwins4Rachel: We used the football hold pretty exclusively while tandem nursing.

RebeccaD: Football all the way. They hated crossing, and would kick each other. When they got older, I sometimes pinned their arms under mine or separated their heads with a rolled up blanket so they wouldn’t bother each other.

Dana: I remember getting extremely creative with the positions of the babies in order to tandem nurse. It was something I was actually quite proud of. I didn’t use the boppy too often, but rather lots and lots of pillows.  I encourage any new mom of twins to get real comfortable with having tons of pillows stashed conveniently around the house. (And don’t forget lots of burp cloths stashed in the couch cushions!) Also, don’t be afraid to stack those kids on top of each other! Here is one position I used often:

468051998_e29e4bb03bJenW: I sat in the middle of the couch with the eZ-2-nurse twin pillow, after starting with a boppy but finding it wasn’t enough. I put a baby on each side of me in a boppy so they wouldn’t roll. I maneuvered them both to the pillow first then got them to latch. By about 6 months they were more efficient so it was faster to do one then the other occasionally. Plus, by then they weren’t as interested in staying on the pillow.

ldskatelyn: When I was seriously, regularly, doing tandem feedings, I generally did two football holds, as it gave me the most control over their bodies, keeping them from rolling, allowing me to position their heads correctly. However, kind of just for fun, when I was no longer tandem feeding, but because they were both starving, my husband and I would put our twins into all sorts of different, not-found-in-books, positions. One these was me lying on my side, and feeding them one on top of the other! Another was me lying on my back, and letting them both suckle against gravity.

Dory: When tandem feeding, I only use the football hold. At the hospital, we tried layering them during one feeding, and I was uncomfortable, they looked uncomfortable, and I was on edge the whole time. Once I switched back to the football hold, I felt like I was able to breathe again. One night I was really sick and couldn’t get out of bed. My husband brought me the babies one at a time and I had them against my body and nursing them while we were both on the bed. I haven’t tried that with two babies though.

Did you tandem nurse in public? How?

RebeccaD: Unfortunately… yes. In order of embarrassment: DayOne, a breast-feeding friendly store where my MoMs group had meetings, in the car (with my pillow), on a public park bench (supported by diaper bags and covered by a blanket), on the lawn of a museum with my top almost totally off (they were starving, I was alone, it was a bad day). I usually nursed one right after the other when we were out.

ldskatelyn: I remember feeding both of them at the same time once while staying at my brother’s house. They were both super hungry, so I put my cover on, and fed them that way. It was not the most comfortable (I don’t think I had my Boppy pillow with me) as I was sure I was going to flash his children. Although, it was super funny when one of my nephews commented that his mom only feeds one baby from both sides.

Sadia: Nope. I never figured it out. I easily nursed one — I loved empire opening nursing tops for cradle hold breastfeeding — while bottle feeding the other by about 2 months. If I was walking with our stroller, I’d just push it with my hip while cradling a baby in one arm and holding a bottle for the other baby with the other hand.

Janna: No. When we went out the boppy didn’t really work without my recliner. It wasn’t high up enough, unless I could find a recliner chair with the right size arms. I never did find a convenient way to tandem nurse outside of my home, so I would either stay close to home and only do short outings, or if we had to be out during a feeding, take bottles with expressed breast milk and feed the boys bottles (usually my husband or another family member or friend would help with the feeding) and then I would pump with a homemade, extra large hooter hider giving me privacy.

Mercedes: Nah. I am all for breastfeeding in public and have done it everywhere from cafes to castles to the stands of a Formula 1 race. But it’s always been one baby at a time. Just easier and less conspicuous that way.

Dory: I don’t tandem in public because I don’t have big enough pillows with us. It is easier to feed one at a time and just hold them or prop my arm on a chair. I don’t have the “mom arms” yet to hold both at once and nurse for an extended period of time.

RachelG: No – I really needed my full setup to be able to tandem nurse successfully. In public, I’d either nurse one at a time or feed them a bottle.

Did prematurity play a role in your attempts to tandem feed?

Sadia: Yes, yes, yes. First, there was the matter of the NICU. My babies were tubefed for their first days, so the pump and I got good and intimate. I was only allowed to try breastfeeding once (M only) during my daughters’ hospital stay, so I couldn’t even try tandem nursing until the babes were 3 weeks old. Their sucks were so weak and their muscles so underdeveloped, each nursling needed my full attention during our nursing sessions. Their tiny stomachs and weak sucks meant that they were each at the breast for 45 minutes at a time. I didn’t exactly have a whole lot of wiggle room to try out new positions because I was terrified that they’d drop back below 4 lbs in weight and have to be rehospitalized. Even during maternity leave, our pediatrician had me keep two meals of high-calorie formula enriched with Poly-Vi-Sol in our routine per day just because they had so much weight to gain. J was 3 lbs 6 oz at birth, M 3 lbs 9 oz. Neither baby had achieved 5 lbs when they were released from the NICU. I’d pump during their formula meals.

Janna: No, my boys were born full term, both weighing over 7 pounds. I do think that this is certainly one reason why nursing came so easy for the three of us.

RebeccaD: My boys were also full-term (5 lbs, 15 oz and 6 lbs, 5 oz), which really helped. Baby A was a champion nurser right from the jump. Baby B had a weak latch that never totally resolved, but my let-down was sensitive enough to make it work. I felt terrible when he had to start formula supplements at 6 months, but the lactation consultant pointed out that tandem nursing helped let-down so much that if he wasn’t a twin, he may not have breastfed as successfully as he did, or for as long. That is a tandem nursing success story!

Mercedes: No. My twins were early term, born at 37 weeks and 1 day, although they were small. My daughter, the bigger of the two, was actually the one with more latching difficulty, and the lactation consultant urged me to be patient as the baby learned. She said that 37 weeks is still early and some babies just need more time.

Dory: We were so fortunate that our twins were 36+5 with no NICU time, so we could nurse right away.

RachelG: Not really. My twins were early term (37 weeks), and while my son did struggle a bit with his latch, we never had serious problems nursing as a result of their delivery date.

ldskatelyn: No. My twins were born a day shy of 38 weeks. They weren’t premature. One of my daughters did need help opening up her mouth big enough, but with help of a lactation specialist at WIC, we were able to figure it out, and I was able to stop hurting.

Twin Breastfeeding Ebook

Manibreasto-Cover-3d-WebWould you like more inspiration, support and tools to make breastfeeding twins work? How Do You Do It? author Mercedes has written an ebook on the subject, Twin Manibreasto. She has a special offer for HDYDI readers! Use the code TWIN5 at checkout to pick up your own copy for $5 (code expires Feb. 10).

We hope that this has helped you get some perspectives on tandem breastfeeding. In addition, you can read about how Dory, who is currently breastfeeding, tandem feeds on her blog, Doyle Dispatch.  If you have any follow-up questions or stories of your own, we would love for you to share them in the comments!

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From the Archives: Infant Feeding

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Categories Breastfeeding, Feeding, Formula, HDYDI Blog, InfantsTags , , , , , 3 Comments

Link Party Button #milkingitI wanted to take this opportunity to highlight the variety of posts here on How Do You Do It? on the subject of infant nutrition, whether breast milk, formula, or some combination. Obviously, there have been several posts over the past several days, but there’s a larger body of wisdom and experience that The HDYDI Moms have gathered here over the years.

Breastfeeding

WBW-Button-150

Expressed Breast Milk (EBM)

Breast Milk and Formula

Formula Feeding

Feeding Tube

We don’t actually have any posts on long-term NG-tube feeding on HDYDI yet, but we have a couple of post-NICU feeding tube mamas in our ranks. If you have questions, please let us know.

Weaning

Infant Feeding in General

Phew. Is anyone else emotionally worn out from the heartfelt intensity of the breastfeeding posts here and elsewhere over the last few days? I cried writing my own post and cried again reading the others. It was cathartic, but it hurt like crazy.

Feeding our infants strikes me as being representative of motherhood in general. We put every part of ourselves into being the best moms we can be, but we never feel that we’re doing quite enough. Or maybe that’s just me.

Do you have other online infant feeding resources to share? Please tell us about them in the comments.

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Guest Post: Breastfeeding two year old twins

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Categories Breastfeeding, Infants, ToddlersTags , 13 Comments

Eva has two year old boy/girl twins, Jordan and Sarah. She works full time as a professor of human development.

What do you think when you hear that someone is nursing TWO YEAR OLDS? Surprise? Discomfort? Disgust? If they’re old enough to ask for it, they’re too old? I might have thought some of these. I cannot explain it, but it’s different when it’s your own children. It’s just Sarah and Jordan nursing, like they have every day since I could walk to the NICU. In the first year of their life, breastfeeding felt all consuming – six times per child during the day, a few more per child at night. I had to plan every meeting, every social engagement, and every attempt to leave the house around nursing or pumping. Now it is in the background, like bathing or brushing teeth. There are moments it is surreal. Recently I was tandem nursing and asking the kiddos about Spanish body parts — “point to your nariz; put your hands on your cabeza…” My son popped off and asked “Bubbie in Spanish.” When your child is asking how to say grandmother in Spanish, it’s a bit odd that they still nurse. On the other hand, it’s our normal.

I recently spoke with another daycare parent. When she found out that my kiddos still nurse, she seemed quite surprised and asked many questions. She nursed her child until 18 months so she’s clearly not against extended nursing. Still, I couldn’t help but feel embarrassed, and caught myself almost blaming my kiddos during the conversation (“they just don’t want to give it up”). Some family members quickly change the subject if I mention nursing and have even expressed concern. At times I feel pride discussing it with others, but there are moments when I feel a bit like the crunchy deviant Mama, like I should be wearing a prairie skirt and braids in my hair.

During pregnancy and the newborn phase when people asked if I planned to nurse I told them I would try and hoped it would work. Once we truly established nursing (after 3 very challenging months) I said I hoped to last a year. After a year I said I’d like to get them through another daycare winter. I have no specific goal at this point.

It has evolved in the past year. At 13 months they still nursed wake up, 10:00 AM, before nap, after nap (their daycare is in the same building as my office), before dinner, before bed, and throughout the night. I gradually weaned them off the nighttime (thank goodness), working hour and pre-dinner ones, finally dropping the lunchtime one at around 20 months. Unless they are sick, they do not nurse between bedtime and 7:00 AM. I never offer, but almost every morning and bedtime they request and I do not deny at those times.

I prefer nursing one at a time. I still occasionally tandem nurse when they are both frantic for it, but over 50 pounds of toddler nursing feels overwhelming. I’m not sure why given that our alternative is just as crazy,  often with one nursing one while reading to the other, book across the nurser’s body, nurser’s feet in reader’s lap. Sometimes when the first nurser seems to be dawdling I’ll give a warning, “three more seconds” and then count off. Other times the waiting kiddo will say “Sarah all done, one, two, three.”

When the kiddos were sick with the stomach bug, I was really happy that they still nurse. The doctor told my husband it was wonderful I still nurse to help them stay nourished and hydrated. I was glad to be able to offer them something comforting, nutritious, with antibodies, and in small quantities. I did at times, though, feel as though my body was letting my daughter down. I certainly do not produce as much milk as I used to (the days of eating with impunity are long gone), and Sarah was so hungry that she would sometimes stop nursing and cry because she could not get enough. I had flashbacks to newborn Sarah nursing for 40 minutes and still not able to get enough, and once again felt a sense of failure at being able to nurture my child.

There are days when I think nursing is less important to the kiddos than it used to be. Sometimes they are distracted and seem more interested in the book that Daddy is reading to their brother/sister than nursing. Other days, though, they cry and beg “Mama nurse…. Mama do one baby… Mama do two babies” as I pick up their sibling first thing in the morning. I still believe that my son as a singleton would have weaned by now, as he’s easily distracted, but if I am around, my daughter insists on nursing at bedtime and in the morning. Sometimes my husband gets them ready for daycare and if they don’t see me before breakfast, they might not ask. I believe twice I have left the house before bedtime and they went to sleep without nursing.

On a recent morning after the kiddos nursed and I was dressing them I asked, “Do you think soon you will want to go to bed and not nurse, just cuddle and read books?” They both looked at me like I’m nuts and said “no!” Then I asked “Do you think some mornings you want to get up and get dressed and have breakfast, and not nurse?” Sarah said “get up AND NURSE.” Tonight I asked Jordan “Do you want to read a book, or nurse?” and he replied “read a book after nursing.” The whole self-led weaning thing has yet to take at our house. I’m not sure how we’ll do it. Perhaps when I leave town? Or a few nights/mornings when I skip bedtime/wake up?  I’ve also read about letting them pick out a present, and saying they can have it when they are all done with nursing. We’ll see what we end up doing. I don’t want to force it in a way that they are dissatisfied with the way things ended.

At any earlier point discussing this topic, I think I would have said that I was not completely ready to be done, or at least, that I’d be sad when it ended. There were nights when Jordan skipped nursing, or a morning on vacation when they both did, and I felt almost teary wondering if the last time had already happened. Today I think I can say that I will be ready to be over when they are ready. I look forward to (mostly) having my body back (no idea what those post-nursing breasts will look like, though). Not thinking about what bra I have on (my son and I actually had a discussion about my wearing the “wrong bra” and “Mama take your bra off” just this week) or how cold my stomach will be when I lift my shirt. Occasionally having my husband say “why don’t you sleep in this morning?” because the kiddos won’t yell “Mama nurse!” until I drag my sleepy body out of bed. Being able to plan a business trip without worrying about clogged ducts and traumatized children. There are certainly things that I will miss, some of which are already long gone. More than two years of multiple times per day, looking down into my children’s eyes and seeing them content and relaxed. More than two years of feeling their warm bodies snuggled into mine. My daughter’s definitive nod when I ask her questions while she’s nursing. My son popping off to laugh or answer a question. I worry about getting enough snuggle time when they no longer nurse, as these days, hugs and kisses don’t always come when requested. Even when we’re done, I hope I find time every day to take each of my babes, snuggle them close, kiss their delicious heads, and tell them how much I love them. The memories of crying, frustration, pumping, bites, and all-night-long nursing are already fading, and I’m mostly left with melty thoughts of the sweet, gentle, cuddly moments. Babyhood is such a short instant in our lives, and I treasure all of these moments with each of them. I’ll miss it and not miss it and never forget it.

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Ask-the-MoMs: Moo Moo

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Categories Ask the Moms, Breastfeeding, FeedingTags , , , , 15 Comments

This post is about, you guessed it, breastfeeding. But more specifically, it’s about the cool art-form known as tandem nursing.

I wish this post could be a “how-to” deal, where any new mother could read it and follow the directions to a wonderful experience of nursing her babies. But I know better. For some moms, nursing will be a no brainer, as-nature-intended act. For others it will take some (okay, a lot) of patience, trial and error and creativity to make it work. And for even more, it will take a lot of heartache and tough decisions, maybe some to continue and some to stop. I fall somewhere in the middle. We had a rough go of it for the first three months and had I been a sane person, I likely would have called it quits. But somehow we kept going and things actually got really good. So good, in fact, that we’re at 13 months now and down to one glorious feeding a day. It’s from this perspective that I’d like to share some of my own tips and tricks. But better yet, I also have compiled some of the wonderful collective wisdom and experiences of my esteemed “How Do You Do It?” colleagues. So if your babies are still in your belly and your planning or considering breastfeeding, or if you’re a newer mom looking for advice, I hope this post can give you some inspiration and some downright practical ideas.

In the Beginning

Hopefully everyone reading this has or will go to full-term and their kiddos will spend no time in the NICU. But because the average twin pregnancy goes to about 35-36 weeks, you have to give this reality some consideration. I count myself lucky, having the boys at 36 weeks and them spending 3 short days in the NICU. I was able to start nursing them the morning they were born, amidst the tangle of heart rate and oxygen monitoring wires. Make sure and take advantage of the lactation consultants at the hospital. They were invaluable, and not just when we were in the hospital. I scheduled consults with them every single day we were there, and they continued to provide free consults for the first 3 months. Truly awesome.

The boys were a healthy 5lb 7oz and 4lb 13oz, however the doc wanted us to supplement with formula from the get-go. I was a die hard “only breast milk” kind of person, but when we found out the boys could get out of the NICU as soon as they started gaining weight, we quickly bagged our “perfect scenario” mentality and started supplementing. Because the boys were technically preemies and lacked the strong suck of a full-term baby, and also because we chose to rest at night and have the NICU nurses feed them, I started pumping after every nursing session, and through the night, with a hospital-grade double pump (Medela). I didn’t realize how important this pump would become! It took my milk 14 days (count ’em, 14!) to come in. I truly thought after day 7 that my body couldn’t produce milk. I came to learn after several lactation consults and tons of research that often times in takes moms with preemies longer to initially produce milk. So if you find yourself in this situation (and hopefully you won’t!), take heart, think positive, and keep on pumping with that hospital grade sucker (you can usually rent them on a monthly basis from your hospital). And if it doesn’t work out for whatever reason, at whatever point you are in the journey, try not to beat yourself up over it. You’ve got enough to worry about as a new twin mom.

We made our first attempt at tandem nursing in the NICU (as did some other HDYDI moms). It was hilarious. I was completely topless, there were nurses and lactation consultants all around, and I was sitting in a wheelchair of all places! I quickly learned that until the boys were better at latching and sucking, it would be a whole lot easier to work with them individually. But as I neared four weeks, I realized my mom was leaving, and I would only have help from my mother-in-law for two more weeks. I would soon be on my own, and I just couldn’t see how it would work if I didn’t tandem nurse. That being said, try and schedule as much in-home help as possible, for as long as possible! Spread out visits and make sure no one overlaps, so you make the most of the help you can get. At one month, we started tandem-trying every day. I had my E-Z Twin nursing pillow, my husband would get the boys situated, and then we’d both try and get them to latch. As soon as one would latch the other would come off, and Jordan would spend the next ten minutes running from side to side. It was a three-ringed circus, literally! I decided to go to our hospital lactation dept. for a tandem nursing consult. The woman recommended nipple shields, as she saw I had a fast let-down and the boys were having a tough time with it (i.e. popping off). As soon as we put the shields on (Medela, again), the boys latched, and nursed away, tandem-style, for the next 20 minutes straight. I started crying with joy right then and there. We used the shields until the boys decided they didn’t like them anymore at 4 months.

Technique

Tandem nursing was easy enough with another set of hands. But how do you do it when it’s just you and two starving babies?! First, you’ve got to find the right location. I don’t recommend buying a traditional nursing glider or rocker, just because they are not big enough or versatile enough to accommodate tandem feeding. Think about places that will be big enough to maneuver two babies without putting them in danger (bed, couch, big arm chair, etc.), and that will also be comfortable for you. Also, most of us used a twin nursing pillow of some kind, especially in the beginning. I used the E-Z Twin (and still do!), but the Twin Hugster and My Breast Friend Twin Pillow also got high marks. Most of us also used the double football hold. There are endless combinations you can try, and sure, I tried them all and always came back to the old faithful football. The most important thing is to find what works best for you and your babies, and trust that it will, at some point, change! The other key to tandem feeding, and this is actually a blessing, is that both babies must stay on the same schedule for it to work! Trust me, you’ll be thankful that your babies are eating and sleeping at the same time once you experience a “mixed” day. Most twins start out on a 3-hour regimen in the beginning. Oh, and you provide a full feeding for each baby with each boob, so no need to worry about switching them mid-way nursing session. However, keep track and make sure and switch sides with each feed so you don’t end up with lopsided boobs.

I chose our couch at first. I situated two boppies with babies snuggled in them, side by side, on the middle cushion. I sat next to them with the E-Z Twin around me, pillowstandem nursing propped underneath it to get the babies high enough to reach the goods, and pillows propped in back of me so I didn’t have to slouch over (this is key! you can end up with a nasty back ache if you don’t pay attention to posture). I was also as close to the padded arm of the couch which acted as an excellent barrier for a rolling baby. I picked up one baby, got him into position closest to the arm of the couch, then picked up the other dude and got him into position (I wiggled the boppy over to act as a barrier on this side). Then I got them each latched and hugged my arms around their bodies to hold them in place. We had reflux babies (god bless them) so I had to burp them frequently. Every five minutes or so, I would take one off, scoop him up over my shoulder, burp him, and getting him back into place, all the while the other guy was still nursing. Geez, it makes me exhausted just remembering all this stuff! Once the boys hit 3 months and had better head control, we moved to our roomy armchair. I’d put one guy in a boppy on the ottoman, snap the pillow around my waist, pick the other guy up over my shoulder, sit down in the chair, get him positioned, and then grab the other dude off the ottoman.

Cheryl, of Twinspiration fame, tandem fed exclusively. Her set up was always on the bed with a nursing pillow and boppies on either side as “on deck circles.” She’d grab one babe and get latched and situated, then reach over and get her other baby settled. Her girl had reflux too, so she’s put Darren back in the boppy (with pacifier – good tip!) with head elevated, burp Sarah, and then switch. Cynthia tandem nursed on her couch or bed with a nursing pillow and boppies on either side. She’d set down one boy on a boppy and hold the other while she sat down. Once the first boy was in position, she’d pick up the second. When she was done, she’d often just stand up with one boy on each shoulder and gently lay them down (simultaneously) in their crib or pack-n-play. I have also read on other MoM blogs of all varieties of pillow and couch cushion propping, babies nursing one on top of the other, etc. The most important thing is to experiment with what works best for you and your babies.

tandem sleepingOne thing’s for sure, tandem nursing gives you a bird’s eye view of some amazing moments. The boys would explore each other’s faces, hold hands, reach up for my face, rest their hands on my chest, and often times peacefully fall asleep. When you all start to get in the groove of things, it’s a beautiful place to find yourself!

All Grown Up

When my boys were about 4-5 months old, nursing became a real pleasure. I could pick them both up at the same time, maneuver the pillow into place, plop them down and let them go to town. They would stop mid-way, crack each other up, crack me up, eat some more, and then I could hoist them both up onto my shoulder and stand up and go on our merry way. And then around six months life got way too interesting for them, and nursing became an exercise in distraction management, along with climbing and standing practice using me as their jungle gym. They were efficient eaters, so the actual nursing only took about 10 minutes, a far cry from the hour-long sessions when they were younger. At nine months, Abel became obsessed with eyes and I quickly found myself reffing eyeball poking matches. But I also found us playing a lot on the pillow after nursing, with the boys each taking one of my hands and flipping it over, and over, and laughing hysterically at the realization that it had two sides. Again, some really amazing, intimate moments. By eleven months the boys had naturally weaned themselves to three feedings and soon after their first birthday they were on the move and couldn’t stop for a second to nurse during the day. Weaning happened just like that. We’re now still nursing once a day, first thing in the morning when they wake up, for a max of five minutes. I give it another week.

Combo Plate

I was the paranoid type for the boys’ first four months and always wondered if they were getting enough nutrition. They weren’t great nurses in the beginning, so we kept up with our supplementing routine, but by 3 weeks I was pumping enough that we switched them off formula and they exclusively got breast milk supplements. I’d get the mini-bottles with an once or two of milk prepped and ready to go next to the couch or armchair, and then after they nursed I’d just grab those bottles and feed them in the same position. Along with other HDYDI moms, we also tandem bottle fed them in boppies on either side of us, as well as in their bouncy seats. I occasionally found myself in a situation where I had to bottle feed one and breastfeed the other (don’t ask), and I would treat this the same way as tandem nursing. Same position, but I held a bottle for one while the other nursed. Krissy nursed her baby girl (and still does!), while has pumped and bottle fed her lil’ guy after his nursing strike at four months. She does it the traditional style of feeding one after the other. Just be assured that whatever scenario of breastfeeding/bottlefeeding you might find yourself in, you WILL find some incredibly resourceful and creative way to accomplish the goal at hand. You’re a twin mom, after all!

Pumping, Pumping, Pumping

I’m going to defer to CraftyLissa’s recent post on pumping, as it’s chock full of fantastic advice. I was a serial pumper and was hooked up to that darn machine ten times a day until the babies hit 6 weeks. I don’t recommend it, but if you have to do it, you have to do it. I then “weaned” myself to pumping only in the evenings, usually three times (twice before bed and once in the middle of the night). It was just too hard for me to pump during the day while I was by myself with the boys. Just remember that you are producing A LOT of milk to feed two babies, so use your pump wisely to “relieve” yourself when it’s necessary, especially when you are weaning or reducing their number of feedings, etc. I ended up with plugged ducts on several occasions, and mastitis once, on account of engorgement. Trust me, you’ve got enough on your plate and don’t want to add this to it. I highly recommend reading Cheryl’s experience with mastitis in Twinspiration. I was so glad I did, because when I noticed the warning signs (hard lumps in boobs, red blotches, fever, feeling like utter crap), I high-tailed it to the doctor and got antibiotics to clear it up right away. And if you’re not pumping to get as much milk out while all this is going on, lord help you.

As much as pumping stinks, you can make the most of it by strapping on the porno tube top (aka hands-free pumping bra) and taking some time for yourself to eat, meditate (the droning sound of the motor is a great mantra), and of course, read the recent posts of How Do You Do It! Be careful though about catching a snooze while you pump. This happened to me one time as I pumped before bed and I woke up an hour later with overflowing catch bottles and sore-as-heck nipples.

Tandem in Public?

If you are like me, you will quickly relinquish any and all modesty once you become a tandem breastfeeder. I nursed the guys in front of my mom and dad, my in-laws, my brother and sister, my best friend and her boyfriend (yikes! but he honestly was the BEST mother’s helper!), countless friends and their children, nannies and babysitters, neighbors. Gosh…I’m just now realizing how many people have seen my boobs! Despite this, I never had the gumption to tandem nurse in public, meaning in the Babies-R-Us lobby or on a park bench. We get enough crazy attention just being out and about, I can’t imagine what kind of stares and comments we would have received if we tandem nursed. But I certainly did not hesitate to nurse the boys in public one at a time. Typically this would be in the women’s lounge at Nordstrom, one of the comfiest spots I found. I’d just keep one guy occupied with a toy while in the stroller or car carrier while I nursed the other. It worked great. If you’ve got the comfort and the technique to tandem it in public, I say GO FOR IT! Totally awesome.

Where to get Help

Obviously, this topic is HUGE! I feel like I just scratched the surface and didn’t even address some of the crazy challenges we encountered over the past 13 months. So here are some excellent places to go for more information. Definitely get a copy of Mothering Multiples by the La Leche League. It’s a great resource to read before your babies arrive and an even better guide once you’re making a go at it. I can’t tell you how many times I read certain chapters of that book. It’s especially useful if you have preemie multiples and when things just aren’t going the way you expected. Twinspiration, by our very own Cheryl, is another great book. It’s funny and entertaining but most of all, it’s a real life account. My husband even read it and loved it. I can’t emphasize enough how important it is to use the lactation consultants at the hospital. They’re free and they are readily available. And most hospitals offer breastfeeding classes you can take advantage of. Also, several HDYDI moms recommend using a lactation consultant for a home visit to help with your set up, technique and measure how much the babies are consuming. If you’re in a bigger city, many local maternity stores have lactation consultants, classes and almost always have a scale where you can drop-in and check your babies weight. I rented a scale from my local store so I could periodically check how much the boys were getting at different feeds. It only cost about $30/week. And then, of course, you have amazing resources with your local La Leche League and MoM’s group. Join these groups, get on their listserves, go to meetings and use these incredible women for their knowledge, experience and support.

Oh, I almost forgot one of the best sources of all – the Internet! Here’s just a few blog posts on tandem feeding (Boobie Monologues, View from Above). And ladies, don’t hesitate to ask questions and add your experiences, techniques, heartbreaks and triumphs of tandem nursing to our comments section.

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