Worried About Supply For Twins

QUESTION

Dear Lactation Consultant,
This is my second pregnancy and I am expecting twins. I'm due October 14th. I breastfed my first child, almost 3 years ago. I had problems with supply; I went to work right at 6 weeks and pumped, but it seemed like I couldn't satisfy him with just the breast and weaned him at 4 months.

Now faced with breastfeeding 2 babies, I am anxious about having enough milk for them. I want to try to feed them at the same time, but will they get enough milk from just one breast? Will I have to feed them every hour instead of every two since they are only getting one breast at a feed? Should I breastfeed one and bottle feed the other alternately at first until my supply increases? I would really appreciate any tips and articles you could get me.

Thanks in advance,
-Gena

ANSWER

Hi Gena,
Congratulations on your pregnancy. Let me see if I can answer your questions below. You may also want to get Karen Gromada's new edition of Mothering Multiples: Breastfeeding and Caring for Twins or More!.

My first question for you is how many times a day were you emptying your breasts (either via baby or pumping). To maintain a full supply, you need to empty your breasts 8-12 times a day. And that can be a challenge when you go back to work at 6 weeks (but not impossible). You may not have had a full supply, but I think it's great that he got breast milk until he was 4 months old. You might also want to look at our BreastfeedingMadeSimple.com site. We have lots of suggestions to increase milk supply and how to combine working and breastfeeding. Unless you've had some kind of injury or rare condition, you should be able to have a full supply. But remember, you need to empty your breasts 8-12 times a day.

Each baby should get enough milk from just one breast. Your supply will adjust. Feeding every couple hours should be fine. But if you are small breasted (or more specifically, have a small storage capacity), you may need to feed them a little more often. You may also need to feed more often in the beginning to ramp up your supply.

Don't alternate feeding one baby from a bottle and one from the breast that unless you have no other choice. If you start supplementing, that can impact your supply.

Something else you should check out is the Mothers of Twins Clubs. They are a wealth of information and practical suggestions.

Let me know if you have any additional questions.

-- Kathleen Kendall-Tackett, PhD, IBCLC

Kathleen Tackett

Dr. Kendall-Tackett is a health psychologist, International Board Certified Lactation Consultant, and Research Associate Professor of Psychology specializing in women's health at the Family Research Lab, University of New Hampshire. She is a Fellow of the American Psychological Association in both the Divisions of Health Psychology and Trauma Psychology. Dr. Kendall-Tackett is a La Leche League leader, chair of the New Hampshire Breastfeeding Taskforce, and the Area Coordinator of Leaders for La Leche League of Maine and New Hampshire.

Dr. Kendall-Tackett is author of more than 140 journal articles, book chapters and other publications, and author or editor of 15 books including The Hidden Feelings of Motherhood (2005, Hale Publications), Depression in New Mothers (2005, Haworth), and Breastfeeding Made Simple, co-authored with Nancy Mohrbacher (2005, New Harbinger). She is on the editorial boards of the journals Child Abuse and Neglect, Journal of Child Sexual Abuse and the Journal of Human Lactation, and regularly reviews for 27 other journals in the fields of trauma, women's health, interpersonal violence, depression, and child development. Dr. Kendall-Tackett is the "Ask a Lactation Consultant" columnist on Pregnancy.org and serves on the Board of Directors of Attachment Parenting International.

Dr. Kendall-Tackett received a Bachelor's and Master's degree in psychology from California State University, Chico, and a Ph.D. from Brandeis University in social and developmental psychology. She has won several awards including the Outstanding Research Study Award from the American Professional Society on the Abuse of Children, and was named 2003 Distinguished Alumna, College of Behavioral and Social Sciences, California State University, Chico.