Maximizing Your Milk Supply for Multiples


The human body is absolutely amazing it is completely possible for a mother to make enough breast milk to exclusively nurse twins, triplets, or more.  Having excellent lactation support in the early days is critical to help maximizing your milk supply for multiples.  The following are 10 strategies to help get breastfeeding your twins or higher order multiples (HOMs) off to a good start.

  1. Plan for a variety of birth scenarios
    Have a birth plan and talk with your doctor about the importance of having as natural a birth as possible.  But, also be prepared for a situation where you may end up delivering by caesarean section.  Realize that the majority of multiples come early.  Having a plan in place for whatever birth scenario will help you to initiate breastfeeding as soon as possible after.  Make sure your doctor, midwife, and birthing facility are supportive of your birth and breastfeeding goals. And talk with a lactation consultant in advance so you have a plan in place in case your babies are born prematurely and you must express your milk in the beginning while your babies are in the NICU.
  2. Initiate skin-to-skin immediately following birth 
    Skin-to-skin contact is wonderful for both mothers and babies.  It helps regulate body temperature and blood glucose levels in babies and allows a new mother’s hormones to flourish for her baby and milk supply.  In fact, did you know that each breast will specifically regulate its temperature based on each individual babies’ needs? Skin-to-skin is possible with two babies at a time, as well as after a c-section (when a mother has help supporting her babies).
  3. Allow first breastfeed to take place while babies are skin-to-skin
    Ideally, skin-to-skin contact should continue through the first breastfeed and first two hours following birth.  This is a critical time of bonding for a mother and her babies, and it can never be returned.  Delay all non-essential procedures until after this time (or have them done while babies are on mother).
  4. Room-in with your babies
    As long as your babies are not in the NICU, keep them in your room.  (And if they are in the NICU, find out if you can room-in with them and/or practice 24-hour kangaroo mother care.)  This will allow you to follow your babies’ feeding cues and nurse when they are hungry.  It gives a new mother confidence to care for her babies and helps to establish a strong milk supply.
  5. Nurse on demand around the clock
    Newborns eat all the time – at least 10-12 times every 24 hours.  It is normal to eat much more than this…even to seem to eat “all the time.”  So you can do the math – twins could mean feeding your babies 20 or more times each day!  It is important to watch your babies’ wet and dirty diapers to ensure they are taking in enough milk. It is important that they have a wide, deep latch and you are not in pain while nursing. And it is important that they seem to come off the breast satisfied – even if this “satisfaction” only lasts a short time.  Other than this, new babies spend their time and eating and sleeping.  A twin or HOMs mom will feel like all she does in the beginning is feed babies. It is okay to feed your babies separately or at the same time – whatever works best for you!  Most twin moms find that it is easiest to start off nursing them individually and then, once each baby is nursing well, nurse them together. Knowing which breast to offer and different positions for nursing twins can make all these feeding options seem less intimidating.
  6. Don’t hesitate to pump
    The first few weeks following birth is a critical time period to establish your milk supply and make sure your body gets the message that it needs to make enough milk for 2, 3, or even more babies.  If your babies are not nursing effectively at the breast, do not hesitate to pump after a feed to ensure your body makes enough milk.  An empty breast makes more milk.  If one baby nurses effectively and the other doesn’t, you will still want to pump to ensure you have an adequate supply for both babies.  (And, you can always “top-off” your baby who is not nursing effectively with your expressed milk.)
  7. Know your magic numbers
    Your goal is to ensure your body makes 750 mL of milk for each baby, within 10 days following birth. If you are expressing to build your supply it will be easier to see the amounts in the bottle. If you are breastfeeding, it is best to watch your babies’ diaper output and feeding cues.  But, if your babies are small and not nursing well, it is prudent to express following a feed.  Don’t worry so much about the amounts adding up to 750 mL/day per child since you babies are drinking your milk from the breast too (and the benefits of feeding at the breast far outweigh pumping all your milk just to see how much is in that bottle).  But, you can keep a log and see if the amounts you are expressing are going up or down – and if they are going down it is probably because your babies are taking in more at the breast . . . which is exactly what you want to happen!
  8. If your babies are in the NICU establish your supply well
    Begin pumping within the first six hours following birth with a double-electric breast pump.  Continue pumping at least eight times every 24 hours to establish your milk supply.  Also, if your babies are in the NICU, make sure to talk to the hospital lactation consultant to develop a plan to build your milk supply and then transition your babies to your breast.
  9. Have a lactation consultant that will support you
    Find out who is in your area while you are still pregnant.  Even better, have a prenatal consultation to get to know her, and develop a lactation plan for establishing a strong milk supply for your situation.  Then, after your babies are born, you will already know who to call if you have any questions or concerns.
  10. Get involved with a mother-to-mother support group
    Though qualified lactation support is essential to successfully breastfeed twins and HOMs, it is equally important to have the encouragement and support of other mothers who have been there.  Some areas even have breastfeeding support groups for mothers of multiples!