Karen Gromada has breastfed twins herself, has written two books – one focusing on breastfeeding for mothers/parents of multiples, has led a breastfeeding support/info group just for women breastfeeding multiple-birth infants/children and is active on a number of online lists for women breastfeeding/mom’s-milk-feeding multiples, etc.
She has a Mothering Multiples: Breastfeeding and Caring for Twins or More Facebook page and a website www.karengromada.comwhere her goal is to provide reassurance and affirmation for the increased effort it takes to lovingly nurture twins, triplets or more while actively promoting breastfeeding and attachment-style parenting concepts.
Lactivist is honored to have this article by Karen, written in response to a question about a twin pregnancy and a breastfeeding toddler on Ask Aunty Lactivist but too long to post as a comment.
Although continued breastfeeding (BF) during a normal pregnancy appears to have no negative effect on the timing of birth, the effect of a BF toddler on a cervix more at risk for preterm labor — and possibly more sensitive or sensitive at an earlier point – to oxytocin is unknown. And ALL twin pregnancies are at higher risk for preterm labor and birth. (Risk doesn’t mean something will happen; it simply means something is a little to a lot more likely to occur. Only 11-14% of twin pregnancies go to full term.) If a woman experiences some preterm labor, if her cervix begins to soften or shorten too early, etc, most likely she will be advised to stop BF her toddler immediately and abruptly, and halt other activities that release oxytocin or prostaglandins, etc., which may contribute to further contractions/cervical change.
So an expectant mother of twins (or more) will need to consider the possibility, and how she might feel, if preterm labor occurs. She may want to ask herself, “Am I a person who is more like to say, ‘If only I’d…’ or am I likely to worry or wonder whether the continued BF contributed?” (I’m not trying to encourage one course of action or another; there’s not enough evidence to judge well in this situation.)
You didn’t mention how often your toddler BF. It may be that a low number has a different effect than the toddler who still nurses many times in 24 hours. Decreasing the number of BF may be worthwhile… Depending on how much he/she nurses, your dietary needs may be increased to care for you, 2 babes inside and 1 out. Whatever the situation, please be honest with your OB/midwife care provider about your toddler’s BF.
It is often difficult for those of us who’ve had previous uncomplicated, term pregnancies to accept that there is more risk for preterm birth and other
issues, and some risks are only present with a monochorionic (one, shared placenta) twin pregnancy. I’m not trying to scare anyone, but women cannot make good choices for themselves and their children if they are unaware of potential implications. Be aware of the possibilities and pay more close attention to your body, Braxton-Hicks (painless) contractions, etc. Learn the signs of preterm labor. Eat well and drink enough fluid. And be honest with yourself and your care providers.
Consider that BF newborn twins when still nursing a toddlers is different than tandem nursing with one newborn and one toddler. It could be helpful – if twins are a bit early, a BF toddler could help with milk production. One just has to ensure that the newborns have first “clain” to mum’s milk for their needs. On the other hand, assuming the care of two newborns, who don’t have much body control, who may be transitioning to breast from some other feeding method – probably due to prematurity –while mom also must fit in adequate breastmilk expression, etc., may affect her feelings about BF an older baby/toddler. It’s not unusual for a toddler to want to BF more often after new babies come home. It may be due to all the milk or to needing more reassurance when mum is so busy caring for new babies, etc.
All the best as you grow into this special pregnancy and as you make decisions that work best for you and your family…
Karen Kerkhoff Gromada, MSN, RN, IBCLC, FILCA; author of Mothering Multiples: Breastfeeding and Caring for Twins or More (La Leche League, 2007)
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