Planning to breast-feed more than one baby? Here's help breast-feeding twins or other multiples, from getting positioned and ensuring an adequate milk supply to combining breast-feeding and formula-feeding.

By Mayo Clinic Staff

If you've decided to breast-feed your multiples, congratulations! Breast-feeding will provide many benefits for you and your babies. Still, breast-feeding more than one baby can be challenging. Understand how to get started and where to turn for support.

Breast milk contains the right balance of nutrients for your babies. The antibodies in breast milk will boost your babies' immune systems. Breast milk also has special benefits for babies who are born prematurely, as are many twins and higher order multiples. Breast milk is easier to digest than is commercial infant formula — especially for premature babies who have smaller, less mature stomachs and intestines. If your babies aren't able to nurse at first, you can pump breast milk to be given to your babies through a feeding tube.

Beyond the health benefits for your newborns, breast-feeding is likely the most convenient and least expensive way to feed your babies — and it might help you lose weight after you give birth. Breast-feeding twins or other multiples also ensures frequent interaction between you and each of your babies.

When you start breast-feeding your babies, feed each one individually. This will give you a chance to see how well each baby latches on to your breast and address any issues. Consider creating a 24-hour chart to record how long and how often each baby nurses, as well as the number of wet and soiled diapers for each baby. If you feed your babies pumped breast milk, record how much they take at each feeding.

Once you've established breast-feeding with each baby, how you breast-feed is up to you and your babies. Some mothers find that breast-feeding two babies at once works well and saves time. Others prefer to breast-feed each baby separately. Likewise, some babies might show a preference for individual feedings. Try different approaches or a combination — such as breast-feeding one baby at a time at night and two at the same time during the day — to see what might work best.

There are several ways to breast-feed two babies at the same time. What's most important is choosing a position that feels good to you and your babies and enables a correct and comfortable latch.

For example:

  • Double-clutch or double-football hold. In this position, you'll hold each baby in a clutch or football hold. Position a pillow on each side of your body and your lap. Place each baby on a pillow beside your body — almost under your arm — so that the babies' legs point toward the back of your chair. Make sure each baby's back is supported by the inside of your forearm. Use the pillows for arm support. Secure the babies' bottoms with the insides of your elbows. Keep the babies' heads at nipple level. Place the palm of one hand at the back of each baby's head to provide support.

    Alternatively, place both babies — head to head — on pillows directly in front of you. Be sure to keep your babies' bodies turned toward you, rather than facing up. Use your palms to support each baby's head.

  • Cradle-clutch combination. In this position, you'll hold one baby in the cradle position — with his or her head on your forearm and his or her whole body facing yours — and the other baby in the clutch position. If one of your babies has an easier time latching on to your breast or staying latched, place him or her in the cradle position.
  • Double-cradle hold. To use the double-cradle position, you'll place both of your babies in the cradle position in front of you. Position your babies so that their legs overlap and make an X across your lap.

At first, you might want help positioning your babies. Enlist someone to help you get situated until you get the hang of simultaneous feedings. Consider latching first the baby who tends to need more help getting started.

Most women are able to produce enough milk to feed twins. Many women are also able to breast-feed or pump enough breast milk to feed higher order multiples. To ensure a steady milk supply, consider these tips:

  • Start right after birth. Breast-feeding your newborns soon after birth and at least eight to 12 times every 24 hours will help you establish your milk supply. The more often you breast-feed, the more milk you'll produce.
  • Pump. If your babies are born early and are unable to breast-feed right away, begin pumping shortly after you give birth to establish your milk supply.  Hospital-grade, double electric breast pumps help stimulate milk production while cutting pumping time in half. Once breast-feeding is well-established, pumping also allows other caregivers to help with feedings.
  • Alternate breasts. Offering both breasts to each baby at each feeding and alternating the breast the feedings are started on, as well as which baby feeds first, might optimize your milk production and each baby’s feeding. This is because each of your babies might have a different style of feeding. Switching breasts will also give your babies different views, which stimulates their eyes. Consider assigning each baby to one breast for a day and then switching the next day or giving each baby a different breast at each feeding.

Remember to always bring your babies to your breast — rather than bending over or leaning forward to bring your breast to your babies.

Exclusive breast-feeding is recommended. Once breastfeeding is established and if you have chosen to do an occasional bottle, expressed breast milk would be the best choice so that formula could be avoided or delayed.

However, some mothers choose to combine breast-feeding and formula-feeding. For example, you might replace one or more breast-feeding sessions with a formula-feeding. Work with your doctor, your baby's doctor and a lactation consultant to determine what works best for you and your babies. If you give your babies formula, keep in mind that your milk production might begin to decrease if you breast-feed or pump less than eight to 10 times within 24 hours.

Getting the hang of breast-feeding twins or other multiples can be difficult, but don't get discouraged. If you're struggling, meet with a lactation consultant who has experience with multiples. Ask your baby's doctor for help. Talk to other women who successfully breast-fed multiples. Ask loved ones for assistance with household tasks and the care of older siblings — or consider hiring household help — so that you can focus on feeding and caring for your babies.

Be patient with yourself and your babies as you experience the challenges and rewards of breast-feeding two or more newborns. Above all, don't be afraid to ask for help.

April 09, 2015