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Breastfeeding and special situations

Will you make enough milk to breastfeed twins, triplets, or more? Want to know if you can breastfeed your adopted baby? Learn the answers to these questions and get tips to help you breastfeed successfully in any situation.

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What do I need to know about breastfeeding twins or multiples?

The benefits of breastfeeding for mothers of multiples and their babies are the same as for all mothers and babies — possibly greater, since many multiples are born early. The idea of breastfeeding more than one baby may seem overwhelming at first! But many moms of multiples find breastfeeding easier than other feeding methods because there is nothing to prepare. Many mothers successfully breastfeed more than one baby even after going back to work.

Being prepared

It will help to learn as much as you can about breastfeeding during your pregnancy. Before the babies are born, you can:

  • Take a breastfeeding class
  • Find Internet and print resources for parents of multiples
  • Join a support group for parents of multiples through your doctor, hospital, local breastfeeding center, or La Leche League International
  • Let your doctor and family members know that you plan to breastfeed
  • Find a lactation consultant who has experience with multiples before your babies are born so that you know where to get help. Ask the lactation consultant where you can rent a breast pump if the babies are born early.

Many twin and multiple babies are smaller or born premature. See the Premature and/or low birth weight section for other tips on caring for these babies.

Making enough milk

Most mothers can make plenty of milk for twins. Many mothers exclusively breastfeed or express their milk for triplets or quadruplets. Keep these tips in mind:

  • Breastfeeding soon and often after birth is helpful for multiples the same way it is for one baby. The more milk that is removed from your breasts, the more milk your body will make.
  • If your babies are born early, double pumping can help you make more milk.
  • The doctor's weight checks can tell you if your babies are getting enough breastmilk. For other signs that your babies are getting enough milk, see the How to know your baby is getting enough milk section.
  • It helps to have each baby feed from both breasts. You can “assign” a breast to each baby for a feeding and switch at the next feeding. Or you can assign a breast to each baby for a day and switch the next day. Switching sides helps keep milk production up if one baby isn't eating as well as the other baby. It also gives babies a different view to stimulate their eyes.

Can I still breastfeed if I'm pregnant?

Breastfeeding during your next pregnancy is not usually dangerous to you, your breastfeeding child, or your new developing baby. Your child may decide to wean on his or her own because of changes in the amount and flavor of your milk. Your doctor also may advise you or you may want to wean your baby if:

  • You have any problems in your pregnancy, such as uterine pain or bleeding
  • You have a history of preterm labor
  • Pregnancy hormones make breastfeeding uncomfortable
  • Your growing belly makes breastfeeding difficult

Your child may decide to wean on his or her own because of changes in the amount and flavor of your milk. If your baby is younger than 12 months, he or she also will need additional food and drink. You will likely make less milk during pregnancy, especially after your 20th week.

If you keep nursing your child after your baby is born, feed your newborn first to ensure he or she gets the colostrum. Once your milk production increases, you can decide how you can best meet everyone's needs, but stay aware of your new baby's needs for you and your milk.

You may want to ask your partner to help you by taking care of one child while you are breastfeeding. Also, you will need more fluids, healthy foods, and rest because you are taking care of yourself and two small children.

Can I breastfeed after breast surgery?

Yes, but the amount of milk your breasts will make will depend on how your surgery was done, where your incisions were, and the reasons for your surgery. Women who had incisions in the fold under the breast are less likely to have problems making milk than women who had incisions around or across the areola, which can cut into milk ducts and nerves. Women who have had breast implants usually breastfeed successfully.

If you ever had surgery on your breasts for any reason, talk with a lactation consultant. If you are planning to have breast surgery, talk with your surgeon about ways he or she can preserve as much of the breast tissue and milk ducts as possible.

Can I breastfeed my adopted baby?

Maybe. Many mothers who adopt can breastfeed their babies successfully with some help. You may need to supplement your breastmilk with donated breastmilk from a milk bank or with infant formula. But some adoptive mothers can breastfeed exclusively, especially if they have been pregnant.

If you plan to adopt and want to breastfeed, talk with your doctor and a lactation consultant. They can help you decide the best way to try to establish a milk supply for your new baby. Options include:

  • Pumping every three hours around the clock for two to three weeks before your baby arrives
  • Waiting until the baby arrives and starting to breastfeed
  • Using devices such as a supplemental nursing system or a lactation aid. This can help ensure that your baby gets enough nutrition and that your breasts are stimulated to make milk at the same time.

What do I need to know about using breastmilk from donor banks?

If you can't breastfeed and still want to give your baby human milk, you may want to consider a human milk bank. A human milk bank can dispense donor human milk to you if you have a prescription from your doctor. Many steps are taken to ensure the milk is safe.

Some reasons you may want or need a human milk bank include:

  • You are unable to breastfeed because:
    • Your baby was born premature
    • Your baby has other health problems
    • You take certain medicines that are dangerous for babies and can be passed to your baby in your breastmilk, like anxiety medicine, birth control with estrogen, or certain migraine medicines.
    • You have a specific illness (like HIV or active tuberculosis)
    • You get radiation therapy, though some therapies may mean only a brief pause in breastfeeding
  • Your baby isn't thriving on formula because of allergies or intolerance

Some mothers give their milk directly to parents of babies in need. This is called “casual sharing.” But this milk has not been tested in a lab as milk has at a human milk bank. You should always talk to your doctor first before using another mother's milk.

You can find a human milk bank through the Human Milk Banking Association of North America (HMBANA). To find out if your insurance will cover the cost of the milk, call your insurance company or ask your doctor. If your insurance company does not cover the cost of the milk, talk with the milk bank to find out if payment can be made later on or how to get help with the payments.

All material contained on this page is free of copyright restrictions and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services. Citation of the source is appreciated.

Content last updated: July 21, 2014


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This information in Spanish (en español)


Breastfeeding fact sheet
(PDF, 160KB)

Your Guide to Breastfeeding
This easy-to-read publication has how-to information and support to help women breastfeed successfully.

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