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Breastfeeding Twins and Multiples 85

●● the infant’s cheeks are full – baby has a great big Progression of a Breastfeed
mouthful of breast
●● When correctly attached, sucking will start
●● more of the mother’s areola can be seen above immediately.
the baby’s upper lip
●● The sucking action will change from short
●● the infant’s cheeks stay rounded during shallow sucks to long deep sucks.
sucking
●● Infants will pause from time to time.
●● the infant rhythmically takes long sucks and
swallows – although it is normal for the baby to ●● Infants become more relaxed as the feed
pause sometimes. progresses.

Although painless feeding may not be a reliable ●● The feed should be quiet, swallowing may be
sign of good attachment, breastfeeding should not heard, but any noisy gulping, clicking or kissing
hurt after the first few sucks. If discomfort sounds may indicate that optimal attachment
continues, the mother should take the infant off the has not occurred.
breast and attach him or her to the breast again,
aiming to improve the attachment. ●● The length of feeds will vary according to the
infant’s needs in the early days. Feeds may be
Indicators of poor attachment long but will probably become shorter as baby
becomes more efficient at sucking through
Poor attachment is suggested if: practice and oral development.

●● the infant’s lips are pursed ●● Infants usually let go of the breast spontaneously
on finishing the feed.
●● the infant’s mouth is not open wide
●● The mother’s nipple should be the same shape as
●● the infant’s cheeks are sucked in with each jaw it was before the feed – any changes in shape or
movement colour indicate that the nipple should be further
back in the baby’s mouth.
●● there is a gap between the infant’s chin and the
mother’s breast Breastfeeding Twins and
Multiples
●● the infant has not got a big mouthful of breast
In the same way that mothers make enough milk
●● the infant’s mouth is central or uppermost on for one infant, it is possible to breastfeed multiples.
the mother’s areola
Mothers approach this in different ways but most
●● nipple pain continues throughout the start by feeding each baby separately until they are
breastfeed confident with positioning and attachment. Once
that has been achieved, feeding two twins together
●● the nipple is pointed, flattened, lined or wedge will shorten overall feeding times. The underarm
shaped after feeding. hold will probably be the easiest to manage both
twins at the same time in the early days. The twins
Problems that suggest poor attachment include: should swap breasts at alternate feeds to ensure both
breasts are equally stimulated, as one twin may suck
In mothers In infants more efficiently than the other.
• Breast pain while • Generally unhappy/
For triplets or more infants, mothers need more
feeding unsettled individual help. If a mother wishes to give some
formula, giving breast milk as well to her infants
• Sore or cracked • Slow weight gain will benefit them.
nipples, engorgement
• Faltering growth
• Too little milk
• Colic
• M astitis or breast
abscess • Explosive or green
stools