Tandem breastfeedingBreastfeeding and other related issues raise many questions for families. Today we have resources such as... LactApp application that we have already presented in Mothers TodayBut it's a topic that deserves further exploration, if only to give visibility to those mothers who breastfeed two (or more) children of different ages. When we talk about this type of breastfeeding, we're referring to those occasions when the older child has not been weaned during pregnancyand shares breast milk with the baby when it is born.
I have been one of those mothers, and although my experience was not as beautiful as others I read in breastfeeding or parenting forums (at that time Facebook was just emerging, and Twitter was simply non-existent), It was worth it not to have forced the older one to give up breastfeeding (I was only 18 months old when I got pregnant again). In the photos, I'm wearing loungewear, my hair is a mess, and I can barely move with two babies in my arms; maybe I would do it again, but I would do it better, so I've gathered the following information that might be helpful to you.
Breastfeeding is surrounded by myths: what if your milk runs out, that if it doesn't feed from a certain age, that the sibling will "steal" the milk the baby needs so much, that "don't breastfeed while pregnant because you could miscarry"; that's why you should always try to find reliable sources and, when possible, verify the information with professionals who are up-to-date on breastfeeding.
What exactly is tandem breastfeeding?
Most authors agree in defining the tandem lactation such as the situation in which a mother breastfeeds two or more children of different agesIn practice, it is usually an older son or daughter who continues breastfeeding when the mother becomes pregnant again and, once the baby is born, both continue breastfeeding, sometimes at the same time and sometimes separately.
Some definitions also include the pregnancy period in which the mother continues breastfeeding the older child, even though the younger baby has not yet been born. For practical purposes, when we talk about tandem breastfeeding, we are encompassing this entire process: Breastfeeding during pregnancythe birth of the new baby and simultaneous breastfeeding of two children.
It's a completely unpredictable situation, and it's very difficult to know how it will go, no matter how many experiences you've read about: I looked at pictures of babies breastfeeding at the same time and holding each other's hands; that didn't happen to me. Furthermore, I would even dare to call the idea that... “There will be no jealousy if they breastfeed at the same time”If the decision is made and help is available, serious difficulties shouldn't arise, but One must be very careful about breastfeeding the older child "without love" or seeing it as “a nuisance” because we prefer to spend more time with the little one. Breastfeeding is a natural act, but sometimes mothers need to do introspectionto name what we feel and act accordingly, even if that means changing the pace of the shots or rethinking the tandem.
Tandem breastfeeding is quite common when babies are very close in age (18 months, 2, 3, or 4 years old...). From a parenting perspective, Those few years' difference still represent a very small emotional distanceThe older child often hasn't yet received enough mothering to feel secure without breastfeeding. That's why for many families It makes perfect sense to maintain this type of breastfeedingThe breast is not only food, it is also comfort, emotional regulation and contact.
Before I begin describing the advantages and disadvantages, and before I give you some useful tips, I would like to point out something that many mothers report and that is also confirmed by different studies: The older child usually resumes very frequent feedings once the baby is bornIt's common to see both babies at the same time as many times a day as needed: on one breast, the powerful sucking of an experienced 2- or 3-year-old, on the other, a newborn calmly latching on whenever hungry. It's intense and exhausting, but for many families, it's also profoundly rewarding. connector and wonderful.
Advantages and disadvantages of tandem breastfeeding
Physiological benefits for the newborn baby
After birth, the baby will benefit from colostrumThat first thick milk, rich in antibodies and immunological factors. When tandem breastfeeding occurs, The milk coming in usually happens earlier and more easily.Because even though preference is given to the smaller breast, the larger one continues to suckle and very effectively stimulates milk production. This additional stimulation:
- It facilitates the start of breastfeeding. with the newborn, who finds a breast that responds quickly and with abundant milk.
- Reduces milk retention and engorgementbecause the chest empties more frequently and deeply.
- It usually helps the baby lose less weight in the first few days and recover it sooner, something that has been observed in descriptive studies on tandem breastfeeding.
Once milk production is established, the older sibling may reduce the amount of solid food they eat for a few days, because take advantage of the abundance of milkThis does not pose a nutritional problem if their basic diet is adequate; however, it is important for the family to have this information to avoid unnecessary anxiety and not interpret this change as a worrying "setback".
Benefits for the eldest son
The eldest son or daughter is usually going through a big change: A new baby arrives who also wants mom.Family dynamics change, and behaviors we interpret as "jealousy" often appear. In this context, breastfeeding can provide significant benefits:
- Allows maintain a space of intense connection with the mother, whom the older child already knows and associates with calm and security.
- Sucking and skin-to-skin contact They help regulate stressSo many mothers describe breastfeeding as "deflating tantrums" and softening the emotional impact of the arrival of a sibling.
- The older one continues to receive antibodies and immunological factors through milk, which strengthens their immune system at a stage when they are often exposed to viruses at nursery school or the park.
As I said, for me it's not 100% true that jealousy disappears, but breastfeeding is stress-relieving, and maybe that minimize the impact to welcome the new member of the family… someone who will also attract the attention of mom and dad.
Benefits for the mother and her breastfeeding
Tandem breastfeeding also has very clear advantages for motherboth physical and emotional:
- The mother usually feels safer and more experiencedShe is no longer the first-time mother full of doubts about positioning or milk production.
- Her breasts They respond better and faster With stimulation, and by increasing sucking, they produce more milk very efficiently.
- The greatest help to empty the congested breastso the engorgement or feeling of heaviness in the first few days is usually less.
- The older sibling's sucking reflex also contributes to a rapid rise of milkThis results in the newborn experiencing a more moderate initial weight loss and a more rapid subsequent weight gain.
- Double sucking after childbirth facilitates contraction of the uterusThis can reduce the risk of postpartum hemorrhage and promote a faster recovery.
In qualitative studies with mothers who have experienced tandem breastfeeding, many describe a increased self-confidence and sense of self-efficacy regarding their caregiving abilities. This positive perception is associated with higher rates of success and duration in breastfeeding.
Potential drawbacks and emotional challenges
Regarding the drawbacksIt's not advisable to exaggerate them, but it is important meet them in order to prepare and seek support:
- You may at certain times feel overwhelmed due to the demands of caring for two children and the lack of rest.
- It is common for them to appear ambivalent feelings towards the eldest son: deep love mixed with irritation or rejection when he insistently asks for the breast.
- You can feel overwhelmed by external judgments (family, friends, even healthcare professionals) who do not understand tandem breastfeeding.
In this scenario, it is essential to have practical and emotional supportThe father or other close relatives should take charge, as much as possible, of meals, clothing, cleaning, leisure activities with the older child, and anything else that doesn't directly involve breastfeeding. As time goes on, this will be very beneficial for both you and the older child. Go out to the park, take a walk and change the sceneryalthough at first he may prefer to be attached to his mom most of the time.
On the other hand, colostrum has a clear laxative effectThat's why your firstborn may have softer or even almost liquid stools for a few days. This is an expected effect and, unless there are other symptoms, it's usually not a problem.
Breastfeeding agitation: when breastfeeding is uncomfortable
A challenge increasingly described in the scientific literature is the breastfeeding agitationThis is a situation in which the mother feels intense rejection, irritability, or even rage towards the child who is currently breastfeeding. This is especially common in prolonged breastfeeding, during pregnancy, and in tandem breastfeeding, almost always directed towards the older child.
Mothers define it like a mixture of sensations physical and emotional:
- Itching, extreme sensitivity, or pain on the nipples.
- Sensation of “not being able to stand it for another second” to the baby at the breast.
- Very unpleasant intrusive thoughts that generate guilt, even though there is no real intention to cause harm.
The available evidence suggests that it may be related to hormonal changes, accumulated stress, and extreme fatigueIt should not be confused with the so-called D-MER (dysphoric ejection reflex), in which the unpleasant sensations are concentrated only at the beginning of the feeding; in agitation, on the other hand, they last the entire time the child is at the breast.
For many mothers it is a relief to know that It's not a personal failing or a lack of lovebut rather a described phenomenon with a biological basis. Being able to verbalize it with other women, in breastfeeding groups, or with non-judgmental professionals helps reduce guilt and allows for the search for strategies, such as:
- Limit the duration or frequency from the shots of the major.
- Search exclusive moments with the little baby, without the older one breastfeeding at the same time.
- Rate a partial or complete weaning of the older child if the situation becomes unbearable.
Breastfeeding during pregnancy: frequently asked questions
Is it safe to breastfeed while pregnant?
As I have pointed out, it is not mandatory to wean the older child if you become pregnant and they are still breastfeeding: Nothing will happen to your new baby if you continue breastfeeding.provided the pregnancy is normal. Available evidence shows that, in uncomplicated pregnancies, Breastfeeding does not increase the risk of miscarriage or premature birthand it does not harm the fetus either.
The uterine contractions that some mothers feel during breastfeeding are due to the oxytocinThe so-called love hormone, which is involved not only in breastfeeding but also in labor and during orgasms. At the beginning of pregnancy, the uterus has few oxytocin receptorsTherefore, it responds very little to this hormone. As pregnancy progresses, these receptors multiply, and towards the end of pregnancy, the uterus becomes much more sensitive, allowing oxytocin to trigger labor. That's why, in a normal pregnancy, the mild contractions felt while breastfeeding are usually harmless and they give way when the child stops breastfeeding.
Now, if you suffer from a threatened abortionIf symptoms of preterm labor, a high-risk multiple pregnancy, a history of premature births, or significant maternal weight loss are present, the gynecologist should assess the situation. In some very specific cases, reducing or temporarily suspending breastfeeding may be recommended, but these are very specific situations. exceptional and not the norm.
Changes in breast milk during pregnancy
Approximately 60% Many infants who are breastfed are spontaneously weaned during pregnancy when their mother becomes pregnant again. This is related to several factors:
- As the pregnancy progresses, many children notice a change in the taste of the milkwhich becomes saltier or different for them.
- From the first few weeks, many women experience a decrease in the amount of milk, sometimes perceived as "I ran dry", even though a small amount is still coming out.
- Around the third trimester, the milk transforms back into precolostrum or colostrumwith a different texture, a more yellowish color, and a composition adapted to the future newborn.
These changes, combined with the natural evolution of child development (the older child already eats other foods and uses the breast mainly for comfort), mean that many children reduce feedings or wean themselvesAt other times it is the mother, due to tiredness or nipple sensitivity, who feels the desire to close that stage.
Breast discomfort and breast care
When a woman becomes pregnant, It increases the sensitivity of your breasts This can make feedings more uncomfortable, even painful. If there are also cracks or significant engorgement, the pain intensifies. This is one of the reasons why many mothers hesitate and ask if they should stop breastfeeding.
Unless otherwise advised by a doctor, it is recommended Continue breastfeeding if the mother so desires.looking for strategies to alleviate the discomfort:
- Change posture of the infant to find the least painful angle.
- Reduce the duration of the major shots or negotiate some key shots.
- Use mild painkillers compatible with pregnancy (such as paracetamol), always under professional recommendation.
After the baby's birth: organizing the tandem
Who breastfeeds first?
Your brother already benefited from colostrum when he was born, now it's your turn: you don't need anyone to tell you this, because you surely do it instinctively.
In the first few days after birth, colostrum production is limited but highly concentratedThat is why it is recommended that, at least initially, the newborn baby has priority and let the baby nurse first. Once lactogenesis II (the "coming in" of transitional milk) is established and breastfeeding is well established, you can:
- Continue offering first breastfeed the baby and then to the older one.
- Breastfeeding both both, if it's comfortable for you and the grip on both is correct.
- Establish soft boundaries with the older child (only after eating, before sleeping, during times of high stress, etc.).
It will all depend on their age, on how you feel and whether you are able to breastfeed without experiencing rejection towards the older child. If your body is screaming "enough," the child is likely to perceive that tension, and then it's advisable to review the situation with love and without guilt.
Emotional management of the eldest son
A newborn disrupts the entire family dynamic. It's normal for the older sibling to want suckles every time she sees the baby suckleand that demand will increase in the first few weeks. Here are some ideas that might help:
- Look for times when the older one can breastfeeding without rushing and with undivided attentionso that he doesn't perceive that the breast "is no longer for him".
- When the baby is asleep, reserve moments of play or walks alone with the older child to strengthen their bond with you beyond the breast.
- If you see him very anxious, it might be helpful. set clear but loving boundaries to the feedings (“not now, after eating it will be”), always accompanied by a lot of presence and comfort.
Recommended positions for breastfeeding two
As for positions, you can use practically all those used in single breastfeeding. adapting them to two:
- Double rugby ball: each child on one side, with their legs towards your back and their head supported in your hands or on a pillow.
- Crossed posture: one of the children crossed over your lap and the other leaning to the side, making sure that both have a good grip.
- Lying on side: you on your side in bed, the small baby on the side of the mattress and the older one behind or in front, depending on ages and size.
- “Horseback” or physiological posture: the older one sitting astride your thigh or next to you, while the younger one is in a cradle or rugby position.
Over time, they will find their own "choreography" for breastfeeding, and you'll see that they can almost position themselves, as long as you maintain a comfortable posture. Protect your back and pelvic floor.
Debunking myths about tandem breastfeeding
Does the older child take the milk away from the younger one?
You may encounter people who love myths and legends, but these aren't based on any evidence. One of the most common is that “the older brother steals the baby’s milk”The reality is quite the opposite:
- The breasts function like a factorynot like a warehouse. They produce based on demand.
- If two babies are suckling, production adjusts accordingly. provide for bothjust like when breastfeeding twins or triplets.
- Initially, it is recommended to prioritize the newborn with colostrum, but once breastfeeding is established there is no "limited ration" that runs out.
Will I become malnourished from breastfeeding two?
Another common fear is that the mother will have to "eat for three" or that her health will suffer. Studies show that, with a balanced, varied and sufficient dietWith the specific supplements recommended by the professional (such as iron or iodine if necessary), the body is able to produce milk for two children without generating serious deficiencies.
It is worth remembering that:
- La Water intake should be adequateBut not excessively: drinking too much does not increase production and may even decrease it.
- El rest and stress management They have a greater influence on production than the volume of food. Sustained high cortisol levels tend to negatively affect lactation.
- Breastfeeding prolongs the period of postpartum amenorrhea and promotes uterine recovery, which also protects maternal health.
Is it dangerous for the unborn baby?
It is also said that "the baby in the womb is lacking nourishment" if the mother continues breastfeeding. As we have already seen, in a normal pregnancy Breastfeeding has not been shown to harm intrauterine development.The hormones of pregnancy (estrogen and progesterone) may slightly decrease the amount of milk and modify its taste, but the fetus obtains nutrients primarily through the placenta.
Only in certain contexts of obstetric risk (Threat of preterm labor, significant bleeding, unintentional maternal weight loss, multiple pregnancy with complications), the medical team may consider partial or complete weaning as a preventive measure. Even so, systematic weaning “just in case” It is not supported by the evidence in most uncomplicated pregnancies.
Does the risk of infection transmission increase between siblings?
Tandem breastfeeding It does not pose an added risk of disease transmission Between siblings, it's quite the opposite. By sharing an environment, germs circulate equally, and what breastfeeding does is allow the mother to produce specific antibodies against pathogens, which she then transmits to both children through her milk.
Special precautions are only taken in certain specific situations:
- In case of oral or breast candidiasis If the infection is very intense, some professionals recommend reserving one breast for each sibling while treating it, in order to try to limit cross-infection.
- If the older one presents active herpetic lesions If the baby is in the mouth or any other area that comes into contact with the breast, it is advisable to prevent breastfeeding to protect the newborn, who is very vulnerable to neonatal herpes.
Composition of tandem breast milk and children's growth
Several scientific studies have analyzed the composition of milk in mothers who tandem breastfeed and compared it with single breastfeeding. The main conclusions are:
- The milk is primarily adapts to the needs of the youngest infantThis means that the content of proteins, fats, lactose and immunoglobulins is what the newborn or young baby needs.
- The differences between the milk of a mother who tandem breastfeeds and that of a mother who only has one young infant are minimal or non-existent from a nutritional point of view.
- The studies that have followed the weight and development of newborns whose mothers tandem breastfeed show adequate growth, and even less initial weight loss and faster recovery.
- The typical breastfeeding “crisis” or bumps in the road They are experienced with less intensity, because the breast is more stimulated and production is regulated more quickly.
For the eldest son, the milk he drinks is still perfectly suitableAlthough its composition is designed for the baby, it will never be "too strong" or "poor in nutrients" for him. The only thing that might happen is that it changes the taste for his palate, which could lead him to breastfeed less or to wean himself.
How to organize feedings and the possible weaning of the older child
Every mother and every family must find the way to organize the shots that best suits your situation. Some practical guidelines that often work:
- There are mothers who prefer breastfeed the baby first and then to the older child, especially during the first few weeks.
- Others choose to breastfeed both at the same time, one chest for each oneThis saves time and can facilitate rest periods by grouping the feedings together.
- If the older brother is mature enough, it can be done to agree with him on the takeoversFor example, tell her that she will breastfeed when the baby has finished or at certain times of the day.
Weaning of the older child may occur at any point in the process:
- It could be the child himself who decide to stop breastfeeding because he doesn't like the new taste of the milk or because his emotional need is satisfied in other ways.
- It could be the mother who, because physical or emotional exhaustion, feels that you need to close that chapter.
In either case, it is recommended that weaning be, as far as possible, progressive and respectfulGradually reduce the number of feedings or the time spent at the breast, offering distractions, play, food, and plenty of physical contact. Tandem breastfeeding can be a little more challenging because the older child sees the younger one nursing, but this can also be used as an opportunity to talk about what's happening, validate their feelings, and strengthen the bond in other ways.
Have a good up-to-date informationFeeling that what you're experiencing is "normal" and being able to share doubts and emotions with other mothers and trained professionals helps you experience tandem breastfeeding with more serenity. Truly, if there is respect for the children's needs according to their ages, and the mother takes care of herself and attends to her own needs, both multiple breastfeeding is possible (twins / twins, triplets) such as tandem breastfeeding, without harming anyone and adding benefits on a nutritional, immunological and, above all, emotional level.
Images - Francisco Jose Galan Leiva, Francisco Jose Galan Leiva, Isabel Garcia Domeño, Mothering Touchhref.