There is an extra special place in my heart for twins and breastfeeding mamas of multiples. I know how challenging and daunting it can feel to even anticipate how you will manage breastfeeding two babies. My own twins were born premature at 31 weeks gestation after struggling with premature labor for 3 weeks. When they were born I thought I knew a lot about breastfeeding after five years of postpartum nursing. Wow, was I ever wrong! I became an IBCLC Lactation Consultant because of my struggles with them. My biggest struggle was accessing help that supported breastfeeding premature twins. At the time, I was told to never breastfeed them exclusively and that I would always have to pump and supplement them with expressed milk and formula. I knew in my heart that this was wrong but finding someone who supported my desire to exclusively breastfeed was discouraging. I can now say that breastfeeding twins is possible! No matter what their gestational age! They may need some extra support initially but exclusive breastfeeding is always possible.
If you are expecting twins, the first thing you need to do is get to know your local IBCLC Lactation Consultant. A prenatal home visit is the perfect opportunity to get to know each other, talk about your breastfeeding goals and create a prenatal breastfeeding plan so that when your twins arrive, you are prepared. Talking about milk expression and knowing where to rent a hospital grade breast pump for the early postpartum days will be valuable information. As soon as your babies are born (and medically stable if premature) try to spend as much time as possible skin to skin with them. NICU's are becoming more and more receptive to early skin to skin between parents and preemies. If mom is recovering from a challenging birth, skin to skin with Dad or siblings is a wonderful bonding opportunity and very beneficial for new babies.
Ask for help with the first feedings. Start with one baby at a time until babies and mama are proficient breastfeeders. I always encourage twin mamas to feel very comfortable with breastfeeding one baby at a time before attempting to latch babies in tandem. Eventually, tandem feeding will become easier and easier and a huge time saver. When babies are nursing individually you will want to coordinate feedings so that one follows the other. You may dedicate one breast per baby or you may alternate back and forth to have both babies latching on both breasts. Milk production is driven by how much milk is removed from the breast so with two nursing babies, most twin mamas will make enough milk to feed both babies.
In the early days you may want to do some hand expressing and/or pumping to help encourage milk production. However, having a good latch is far more important than pumping. When babies are latched well and drinking well, pumping may not even be necessary. Breast compression helps to encourage milk flow and transfer so learning how to use breast compressions during feeds is very important. Your IBCLC will be able to teach you how to assess milk transfer and determine wether supplementation is necessary. Monitoring your babies weight gains will be important but not nearly as important as ongoing breastfeeding assessment.
Twin mamas need extra special care and attention. Breastfeeding two babies requires a lot of energy and support. If you are a friend or family member of a new twin mama, be prepared to help out with meals, cleaning, sibling care and everyday errands. Allowing the new mama to snuggle her babies skin to skin, sleep, shower, eat and rest is the best thing you can do to support breastfeeding. Taking a baby for a burp or diaper change while the other baby is being fed is helpful or snuggling a baby while mom is caring for herself is great but mom should have every opportunity to snuggle and cuddle her babies to help promote and support milk production. Everyone wants to snuggle the new babies but unless you're breastfeeding those babies (or you're the new Dad) all the snuggles belong to mom.
Breastfeeding two babies is not easy but with good support and a knowledgable IBCLC, it can be done!