Saturday, August 6, 2011

Tips for tandem breastfeeding a baby & toddler

Tandem breastfeeding newborn Alrik anb and preschooler Mikko m4yo

I am currently tandem nursing a two-month-old baby and a four-year-old preschooler, so I thought I'd compile a list of the best advice I can think of to navigate through any similar experience. A lot of these are tips to help you as the breastfeeding parent cope with the new situation — not just nitty-gritty on positioning but counsel on emotional balance.

Now, I'm not setting myself up as an expert in this tandeming gig, since it's been only a rather challenging two months so far. And I don't want to speak for parents of multiples who have newborns the same age, although I hope some of the tips will apply to that situation as well.

I mostly want to honor the needs of all the parties involved in a tandem nursing relationship: the young nursling, the older one (or ones), and the breastfeeding mother. Balancing them all can seem like a daunting task, particularly in a culture that doesn't value nursing past infancy, and where tandem modeling is sparse. It's easy to feel alone when you don't know anyone else in real life who's going through this. We're having to make our own village, and I mainly want to add my voice so someone else can say a "me, too" or "I've been there, and here's what I did." So here are some of my ideas for how to think through the tandem relationship. Add your own in the comments.

  • Consider the feeding order.

    If you want to try feeding both at once, you certainly can. Some people like it; some people (like me) do not so much. If you don't, you'll need to figure out who eats first. In most cases, I pick the newborn. Past the first few days of colostrum, there's no definitive need to, but it feels better to me.

    The reasons for this are pretty self-explanatory: The older nursling can eat solid foods and drink other liquids, so the need is less. If the newborn doesn't have free and frequent access to the breast, to drink to satiation, she might not thrive and your milk supply might drop. Not to mention that newborns are typically better at screaming out their hunger (though not always — Mikko gives Alrik a good run). I know Mikko can drain a breast (no nursing breast ever goes completely dry, but to the point of very little flow), because he tells me so. I therefore try to favor Alrik's needs for nutrition over Mikko's if there's ever a contest.

    There might be exceptions to this: If an older nursling wants just a quick suck before heading off to play, rather than a full meal, there's little harm in having him go first. Or if you have an oversupply problem, it might be more pleasurable for everyone involved for the older nursling to take the edge off the fast flow before the newborn takes a turn.

    Just keep a watchful eye on your newborn's growth and wet and poopy diapers. If everything's fine, then everything's fine. (Sorry to sound simplistic, but breastfeeding often is!) Milk is a supply and demand proposition, so it can and will keep up with more than one nursling in most cases.

    If, on the other hand, you're having any problems with low supply, then you'll definitely want to work with a lactation consultant to try to find ways to boost your milk production and take care of the younger nursling's requirements. Since everyone's case would be different, I'll leave that to the experts.

  • Keep the sibling rivalry to a minimum.

    By tandem nursing, you're already steps ahead in this journey. But I've tried to be careful not to fan any competitive fires.

    Use positive language to talk about tandem breastfeeding, reassuring your older nursling that there's plenty of milk to go around. This might help your attitude as well.

    When I want to set limits, I try to make it clear that it's my own choice, not Alrik's demands on me. I want any of Mikko's frustration directed at me (I can take it) and not at the newborn. Try to use neutral or positive language like, "You can nurse for a little bit, and then I need a break" or "The baby's having a turn right now, and then you can have one," rather than language that encourages a divide between the siblings: "The baby needs this milk more than you" or "Big girls like you don't need to nurse." If Mikko asks why I don't want to nurse them both at the same time, I try to emphasize that the "blame" is mine — that I simply prefer to have my hands free. Or if he wants to nurse longer at night as we go to sleep, even if my mind is also thinking that I want to preserve some ready milk for the baby as he's stirring, I'll tell Mikko I need to stop now because I'm tired.

    I love the bond between my boys so far. Every once in awhile, I think, Well, it's because they're milk brothers! And then I remember, No, no, that's just called brothers. Hee! But there is something bonding about mother's milk, and I'm glad Mikko's held on nursing till this sibling came along.

  • Set limits that work for you.

    As I learned during pregnancy discomfort, at some point it's best to let go of the guilt. If you've nursed long enough that another baby has come along in the meantime, you've done good, Mama. This doesn't mean you need to wean, but be open to making changes that make sense for your own emotional and physical health.

    If breastfeeding is a challenge for you right now as you perfect your newborn's latch or correct an older nursling's, if your nipples are at all sore, if you're exhausted still from birth, if you're suffering any postpartum depression, if an older nursling's demands make you feel agitated and stretched thin — take it easy on yourself.

    You might start setting some reasonable limits on when and for how long your older nursling can breastfeed. Maybe only in a special chair, or at certain times of day (in the morning or down to sleep, for instance), or for the length of a song or a countdown. Mikko became, through the duration of the pregnancy, pretty good at unlatching if I told him I was done. His responses have gotten a tad bit slower with the milk resuming, but he mostly will release if I tell him I need to stop for now. He'll immediately ask when the next nursing session can begin and start bargaining for it, but at least we have that option for negotiation.

    On the other hand, if your older nursling is showing signs of weaning before either of you is ready, you might want to rethink such limits and try to nurse your older nursling more frequently. And there's no rule that says you must limit one of the nurslings, so if things are going well for you nursing more than one on demand, continue on.

    I don't really want to encourage setting limits on your younger baby's nursing, without knowing your particular situation in terms of milk supply and preferences, but I have personally felt more peace about having Sam give the baby an occasional bottle of expressed milk this time around when I just need a little space, or to get some deep sleep. I pump as I wish to, mostly in anticipation of donating but also to have a little put by for just such occasions. Other than that, I've continued letting Alrik nurse on cue and trying to make sure there are adequate milk stores in my breasts ready for him when I suspect he's going to be hungry. This has meant telling Mikko he can have, for instance, only one breast at a certain feeding, or asking him to stop earlier than he wants to if the baby wakes up.

    Another limit I've put into place is in what position Mikko can nurse, and what he can do during the session. It feels best to me if he's in a pretty standard cradle position, because his latch is best then. It makes me feel yucky somehow if he's doing a lot of twisting around and touching of my breast with his hands while he nurses, so I've been helping him hold still while he nurses. Experiment with what works best for you — sometimes a little change can make a huge difference in your comfort levels.

    Another limit to consider is nursing in public. I know for me, I've felt less comfortable nursing Mikko in public as he's gotten older and older. I really don't relish tandem nursing in public, because I mostly end up showing a lot more skin than I would be comfortable with — not to mention how unusual tandem nursing is in my culture and therefore what a strange sight we would be. I'd rather not attract the attention, though I absolutely leave that up to other parents to decide for themselves. If you don't want to tandem nurse in public, or you want to do so only in ways that make you feel comfortable, you can set those limits as well. For instance, you could start availing yourself of nursing rooms even if you hadn't before, or you could limit public nursing sessions in length. You could also choose to nurse each child separately in public but not both together. Work through what feels right to you, and then let your older child know, gently and repeatedly, what the new rules are, being willing to offer alternatives such as cuddles or a drink of water or snack.

    You might also want to night wean your older nursling if that's still an issue, or cut down on the amount of time he spends at the milk bar. Dionna had some great tips on that subject, and there's a giveaway of a children's book about night weaning currently on Natural Parents Network.

  • Keep on top of your own nutrition.

    Breastfeeding tends to make you hungry and thirsty. Breastfeeding more than one can feel like it's doubled the desire.

    Make sure you have a drink nearby when you need it, and eat meals that keep you feeling strong. You might need to enlist someone else's assistance with this, especially in the early days. Don't be afraid to ask for help if you need it.

    As far as weight loss goes, though, try not to have too many expectations. I had hoped I would quickly lose all my pregnancy weight. It hasn't happened yet. At all. For some women, it will be the reverse problem: keeping on weight when breastfeeding is sucking it off too quickly. Whatever the situation, try to eat and drink to satisfy yourself, and stay as active as you can to help your metabolism cope with these new demands. Most of all, be patient with your body: It's been through a lot, and is still doing some powerful stuff. It's nourishing two other human beings in addition to itself! If you need further help in setting up an eating plan that will preserve your health but that won't affect your milk supply, talk it over with a lactation consultant or doctor who can refer you to a breastfeeding-friendly dietitian.

  • Expect some emotional challenges.

    I was so excited that Mikko hadn't weaned during pregnancy, since I would have felt it was premature given his attachment to nursing at the start of the pregnancy. And then when tandem nursing began, I suddenly started wishing he had weaned after all. The reason is how his nursing now makes me feel: uneasy and agitated.

    Just knowing that I'm not the only one who feels this way has made it a lot better. It's a common complaint of tandem nursers, and it's something that I know can fade with time. I'm trying to be patient and own it as a feeling only I am having — Mikko doesn't know I'm having this strong aversion to nursing him, and I'm trying to keep it from him for the most part. By "for the most part," I mean that he knows I'm setting limits and get impatient when he nurses, but I'm definitely trying not to use any language that lets him know I find nursing him distasteful right now. He's still the same little child who was happily nursing before this new baby came along, and I want to respect that.

    As I mentioned before, having him touch my breasts as he's nursing somehow makes it worse, because he strokes his hands around and it bugs me. Become aware of your own emotional responses to nursing, and figure out what you can do to mitigate the negative feelings: Distract yourself, limit the sessions, take steps to curb behavior you find irritating. And then be patient, because likely it will pass and nursing both children will become pleasurable again.

  • Work on that latch.

    One thing you don't need when you're nursing two kidlets is sore nipples. It goes without saying (but here I'll say it anyway) that you should make sure your baby's latch is nice and deep and wide and that there are no problems with a tongue tie or other obstacles. However, it can be just as critical to your breasts' health to make sure your older nursling's latch hasn't become lazy, particularly if your milk dried over the pregnancy so the effort-reward system wasn't in place for several months.

    The older the child, the easier it can be to verbally and visually give some cues to correct the latch. Demonstrate a wide open mouth and then take your older nursling on the breast as far as you would your newborn. Point out when it feels fine and when it hurts. Caution against the use of teeth. Even with an older nursling who's not verbally adept (as a toddler might be), you can send a message by gently unlatching when things don't feel right.

  • Find the positions that work.

    If you want to try tandeming both at once, you can have your older nursling sit in your lap sideways, and place the younger baby basically in the older one's lap. Or you can have both sit on the side of you and do the football hold on either side, or have the baby in your lap and the older child sitting or standing alongside. If you're lying in bed, feeding your baby on the bottom breast, your older nursling can lean over the top of you to latch on.

    But, if you don't want to feed both simultaneously, you don't have to. For some mamas, it's just too much at once, and that's fine, too. Feed one and then the other. As your baby grows, you can switch around the feeding order and the positions as they work for you and your nurslings.

  • Consider — just consider — weaning.

    If you're anything like me, you attach a lot of value to the idea of child-led weaning — and therefore a lot of guilt to the idea of parent-led weaning. But, first of all, this need not be so. And, second of all, starting from that mindset can be detrimental in itself.

    To explain my second point, feeling like you can't wean can leave you feeling trapped and resentful. Then, instead of choosing to breastfeed your children, you now feel like you have to – or, worse, that your children are forcing you to.

    If you let weaning be an option, you can think about it rationally and decide whether it's right for you. I had such a block about thinking through weaning that I didn't want it even in my mind. Finally, I let myself think about what a gradual and gentle parent-led weaning process would look like: talking over with Mikko the idea of weaning, reading some books together about it, gradually choosing which nursing sessions to drop, maybe even setting a date where he would be done with nummies (some parents choose a particular birthday). As I considered it, I realized it didn't feel right to me at this point. Suddenly, that made me feel so much better. Instead of avoiding the subject of weaning, I was actively choosing to continue nursing for the present. It wasn't waiting in my subconscious anymore, about to jump out and bite me, as it had felt. And now my decision to continue nursing felt more like a choice and less like a constraint.

    That said, your choice might be to pursue weaning in the manner I described above, and that might be the best option for you and your family. It doesn't even need to be an all-or-nothing approach. Maybe you cut way down on nursing your older child for a few months, but then add a session or two back in when you're not feeling so overwhelmed. Maybe you cut down enough length and frequency of nursing sessions that you no longer feel the need to wean fully. There can be a gracious balance between a parent's needs and a child's needs, and you can explore to find what it is for you.

    Just as a note on this, I don't think as attachment parents we're obligated to protect our children from all frustration and disappointment — and certainly not from all negative emotion. Will a two-year-old or five-year-old who loves to nurse be disappointed that you're cutting down on nursing sessions? Yes. Might such a child cry and be upset? Absolutely. Your job as a parent in that moment is to comfort and be present — but it's not a given that the only solution is to continue nursing at the expense of your own physical or emotional well-being. And it might be that you can't even be the one giving all the comfort as you need to concentrate on a baby as well and might be feeling tapped out — this is when a co-parent or other trusted caregiver such as a partner can step in and do some of the soothing.

    I'm not saying anyone in particular should or should not wean — as I said, I've chosen not to for the time being after considering it thoughtfully. But I think we need to take some of the guilt out of the subject. While it's a blessed and heavy responsibility to raise our kids in a healthy fashion, let's still be easy on ourselves and our own limitations as human beings who happen to be parents.

  • Respect your child's feelings.

    Take stock of how attached your child is to the nursing relationship. If you want to cut back or wean, do so gently and respectfully if at all possible. If you can stick it out until things get better and your child can make the choice to wean, find a way through that doesn't leave you feeling like a martyr but like, as you are, a mother. Sometimes we do sucky things for our children's sakes, and that's OK. Sometimes we can't do sucky things even for our children, and that's OK, too. Find the balance that works for you, but keep your child's needs and desires in mind as you seek a compromise.

    By the same token, try not to overdramatize your child's emotions. The weaning process is just as big for the parent as for the child — sometimes it might be more so. If your older nursling is ready to move on, reassure her that it's all right for things to change. If she needs time to process and wants to go back and forth from nursing to not, know that it's not uncommon, and try to be present with her in the moment.

  • Find other ways to connect.

    Whether you're continuing to nurse full-throttle or cutting back or cutting an older nursling off entirely, it can help to start now to emphasize non-breastfeeding ways you and your older nursling can bond. Start a ritual of back scratches before bed; give a hug when she comes in range; cuddle in a family bed; talk to him about how happy he makes you and how much you love being his parent.

    Mikko's even started his own substitutes for nursing, such as patting the tops of my breasts and even hugging and kissing them. Do I find this a little weird? Yes, but also normal, because I know other older nurslings have done the same in their time. He also zooms in for frequent hugs from me, as if to reassure himself that the connection he's enjoyed for four years now is still available.

    Whether it's soon or later, your older nursling will one day be a nursling no more. It's always a good practice to seek out new gentle ways to connect with the people you love.

  • Have patience.

    Everything changes. Particularly the things about your children you're certain will never change. All they do is grow, after all.

    Enjoy these tandem breastfeeding moments. Memorize their profiles as they snuggle in close to feed. Smile as the older sibling helps the younger to latch. Congratulate yourself for nurturing these two young lives, and hug them close. It will just keep getting better.

For more on tandem nursing, I found Nursing Two on informative and reassuring.

A book to consider is the LLLI's Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond, by Hilary Flower.

More blog perspectives on the subject, featuring different ages of children & a range of experiences:

What worked best for you when navigating tandem nursing? If you're considering tandeming, does it help to have some been-there-done-that perspectives?


I’m celebrating World Breastfeeding Week with Natural Parents Network!

You can, too — link up your breastfeeding posts from August 1-7 in the linky below, and enjoy reading, commenting on, and sharing the posts collected here and on Natural Parents Network.

(Visit NPN for the code to place on your blog.)


Christy said...

Great thoughts and advice. And may I say, you look so beautiful... just radiant!

Laura said...

Thank you for this! Saving it off to think and re-read as November approaches....

One thought, re order:

Or if you have an oversupply problem, it might be more pleasurable for everyone involved for the older nursling to take the edge off the fast flow before the newborn takes a turn.

Yes, this is what may happen if I am the same this time as I was with my first. I had such a strong over-active let-down that he'd pop off and cry his heart out. I got the point when he did that once and it kept a steady STRONG stream...for several seconds. But as he got older he could deal with that just fine. If we deal with that again, having him take that first little bit will probably make life a lot happier for everyone. said...

This was amazing and so helpful to read. Great advice, well-written from a caring perspective (for everyone!). It's funny b/c I just wrote a post for WBW on Pregnancy and Tandem Nursing (and linked this post as a resource for others-- I wrote about my own pregnancy nursing story and came to the no guilt place. That has taken a while, and it has been hurtful. Having you affirm what I had concluded just in the last few days feels wonderful. THANK YOU! I am feeling much more positive now!

Mo Chuisle said...

I stumbled upon this post and your site. I'm glad I did. I have a 3 week old and a 22 month old. My 22 month old hasn't bf in about a year yet when my milk came in, since the begining of the third trimester, she has started to nurse. Since having her brother she's started to nurse more and more. Its nice to read your tips and know I'm not alone in tandem nursing since non of my friends do it. By the way that's a beautiful picture of you and your children at the begining of this post.

Brenna @ Almost All The Truth said...

I never had the experience of tandem nursing, but what incredible advice! I have to say your photo is so gorgeous!

Lisa Baker said...

Thank you so much for this post. My second is arriving in December, and my first will turn four in February, so by next year I'll be nursing a four year old and a two month old! I was actually really opposed to the idea of tandem nursing for a long time, and it's the main reason I've waited so long to have my second (my husband was ready for another baby a LONG time ago!). Posts like this make me less scared! And actually, the more I think about it and read about it, the more I'm actually kind of looking forward to it. My daughter has finally accepting cutting back a LOT (on her third birthday she was still nursing every three hours round the clock, so three or four times a day is a big relief now!), and I'm sort of enjoying imagining the bonding that tandeming can encourage between my kids and the way it will hopefully reduce sibling rivalry. Not sure that I'll actually enjoy it, but it's good to know it's normal if I don't. :)

And I especially love your point that parent-led weaning IS an option. I'm going to keep that in mind for sure. I'm kind of a recent convert to the whole child-led weaning idea anyway, although I love it and I'd *like* to do it. But I'm going to remember that there are other options. Now that my daughter is (finally!) learning other ways to soothe herself and connect with me, I can imagine a path toward weaning a lot more easily than I could have even a few months ago.

I'm a full-time mummy said...

Thanks for this post. I'll definitely keep this in mind when my 2nd child comes along in Sept.

You look beautiful!

Anonymous said...

I was so happy to read this and see that I am not the only person who gets irritated by the stroking thing when the older one is nursing. I know it soothes her but after a while, I feel ready to scream. She is always in motion, so that's just another way she moves around, but I have to tell her to stop because it drives me nuts. And the lazy latch with the older one is another thing I've encountered! Thank you so much for sharing!

And that's a beautiful picture!!!

Zoie @ TouchstoneZ said...

Thank you so much for the kind mention. I'm going to capture an updated version of the photo soon. My two oldest sons are now 5 & 3. They still tandem nurse irregularly. And they still hold hands like that when they (on rare occasion, now) tandem. They also hold hands with their younger brother while he's nursing, whether they are joining him or not. I think they like to enjoy the nurture that is mama milk.

I think that your point about careful speech to help with sibling rivalry is spot on. So far, we have had very small spots of jealousy or rivalry. I think it is due in large part to their early experiences together at the breast. They model what they hear and see, especially in a moment of openness such as breastfeeding creates. The fuzzies take over us all and love bonds are created for the long-term.

Specifically with breastfeeding, my older boys both enjoyed teaching and helping their younger brothers to nurse. The idea of nurturing in a space where they felt nurtured isn't lost on me.

I think you've really summed up the options and flexibilities inherent in successful tandem (and tri-andem) breastfeeding. A couple of things I'd like to reiterate in support of your excellent points, include remembering that the circle of breastfeeding is like a dance. Everyone's needs are important and keeping connected with one another's rhythms keeps everyone content. It's easy to give too much and not bring an open heart when breastfeeding. Children can definitely feel that. Managing three active nurslings, including a newborn and managing PPD, I had to set gentle, firm limits to keep my emotional well full. In setting limits, I would sometimes sing a song or tell a story both to distract myself from touched-out feelings and to gently set a time limit for an older nursling.

A nursing older child can really help with oversupply (a major problem for me) but I do notice that when my oldest nurses, it also has the effect of increasing my supply for awhile. So, being mindful of managing supply, especially until the baby is able to manage a strong let down and/or oversupply is important. Those resources you mention, have excellent advice for learning about management.

And the books you recommend should be issued when milk comes in. The strange size-morphing that happens at times and even the strong momentary (or longer) aversions need to be acknowledged as normal. I had major guilt until I heard other stories about it happening to others.

Okay, I've written another blog post length comment inspired by another one of your excellent posts. I'll hold my piece now ;)

The Happy Hippie Homemaker said...

Such a beautiful blog post! I can empathize with you on so many points!! Thanks so much for the advice and for all the links.

Laurie said...

I really enjoy your posts and this one about tandem nursing really rings true to my situation. Thanks for sharing!

Sarah said...

Ran across this blog and wanted to say "thank you". I'm not tandem nursing< Only nursing one baby. But live in a small town, only surrounded by people whom did not nurse at all Or nursed a max of 3-6 months. My son is 19 months and will be two this coming summer. First 1-10 comments i received, that he shouldn't nurse anymore I let slip by. But lately comments have been hurting my feelings. Never speaking or meeting mommy's that nurse over 1 year< it does bring comfort thinking/seeing other people will continue to nurse (till my/or their son/child doesn't want to... Either.. (me) In Shock< almost in tears -stopped nursing. My son fussed the rest of the time- till we left. When I was leaving I there happen to be another NY state police officer outside of the building. So I walked up to him and told him what happen. (still shaken up/upset) ... thinking I would be told SOMETHING nice... OR even state the LAW!(that woman can breastfeed in public places)... Instead the man/police officer< started laughing at me! (meanwhile I'm still shooken-up!)... "Ohhh (LOL) She is Old School!" He said. Me... in shock (again) tried to explain how "I dont understand?" and if nothing< I would hope that a person ... should *AT LEAST* know and follow the law! I tryed to explain were I was sitting quietly away from anyone/ just me and baby....(anyways)... and that she really hurt my feelings. ....Him (still giggling the whole time)!. After realizing this man thinks "this is a joke/ or doesnt care' ... I walked out/done!

.... This day/Circumstance even now still bothers me! This happen when my son was only 4-6 months old!... LOL... I think I should take a random walk in/around... (AND WHIP A TIT OUT!) In front of people/police.... i guess if I cant sit by myself quiet/back corner/away from people: when my son was a lil' baby... What reaction would I get walking in with a two year old (and NOT hiding away alone)!? Ha-Ha, I guess I just have to laugh... at the thought.

I am continually amazed by people (Daily)... (in wonder)... The talk, actions and beliefs! ... I don't understand?! ... To me< it would just seem obvious< to look at others/ treat others kindly! Love OR at LEAST Love (they are whom they are)<perfectly created by someone that knows better then me:). If the day ever comes when I don't think/or realize this differance... Hummm???, I just wouldn't want to BE anymore, ... because I wouldnt be me :)

Let God Guild me< To never remove me from his path. Or allow me to walk behind another persons trails.♥

Lauren @ Hobo Mama said...

@Sarah: So sorry you've gotten so many negative comments, and so little sympathy from a police officer, too. You sound like you've got the wisdom and compassion to help others through this now if called upon. Our society's hang-ups on breastfeeding are so silly. Hugs to you!

sharon said...

Thanks for this article. I am nursing my 8 month old and my 3 1/2 year old. No one but my sister knows as I live in a town where very few people nurse past 3 months if they do at all. I would be considered a freak show. But for the most part I don't care except for at night. They both sleep in my bed and there's kind of an all you can eat buffet going on. If one cries they wake the other up and I really get very little sleep most nights. I also have very little support from my husband who is upset that I didn't wean the older one before the baby came. And he will bring this up every time I complain about having a rough night. My main complaint about tandem nursing is that I can't lose any baby weight! This is my fourth child and I've always lost the weight within a year. This is the only time I tandem nursed (the first 2 I only nursed for 17 and 20 months..I was embarrassed that I was the only one I knew who nursed that long and weaned them before I was ready) and this is the only time I have had a hard time losing weight. I've only lost 5 lbs since I left the hospital 8 months ago! I still look 6 months pregnant which is a little upsetting! Really hoping it starts to budge. I too have a sweet tooth when I nurse but the last few months I have eliminated much of the sweets and snacks and still the scale won't budge! But overall I cherish the time nursing my babies. I have been pregnant or nursing almost constantly for the last 10 years and am pretty sure we are done having kids. For all the complaints, it will be a sad sad day when I have no nurslings!!

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